Self-help strategies for anxiety

If you feel that your anxiety is affecting your daily life, it’s good to check in with your doctor. There are some physical conditions that can cause anxiety, so ask your doctor for a full physical check-up, if possible, or to check for medical conditions known to cause symptoms of anxiety, such as hyperthyroidism, Vitamin B12 deficiency, or heart irregularities.

Once you’ve been reassured that there’s no physiological cause, there are many ways you can help calm the body and the mind. These two work on each other in a two-way system, so you can do things to calm the mind and they will slow down the body’s anxious reactions (this is known as working ‘top down’), or you can work on the body and notice how your mind begins to become more calm (this is known as working ‘bottom up’).

CALMING THE MIND

When we start associating certain things with making us anxious, we begin to avoid them. This is completely natural and ties in to our evolutionary psychology – anxiety is there as a prompt to keep us away from dangerous situations. However, when anxiety becomes a common or everyday state, it comes into play with situations that are not potentially dangerous in terms of our physical safety. And it turns out that avoiding things that make us anxious isn’t a good idea – research has shown that avoidance increases anxiety, rather than lessening it. So someone might start by avoiding large gatherings, then small parties, then even an outing with close friends, because the avoidance has fostered a sense of anxiety in ever-smaller situations. This means that anxiety is best overcome by facing your fears rather than avoiding them, and the earlier this is done, the easier it is to ease any anxiety that has become associated with particular things, people or events. No one needs to do this on their own, so be sure to seek professional help if this feels right for you.

Here are some other ways for calming the mind:

  • Mindfulness has proved to be especially useful as a way to ease anxiety both short- and long-term, so you might want to consider using a mindfulness app (such as Headspace) or website (I like AudioDharma.org but there are lots more to choose from). The Oxford Mindfulness Centre – home of mindfulness-based CBT – has lots of resources, including a great three-minute ‘Breathing-space Meditation’ to calm the mind and body – click here to listen now.
  • See your anxious thoughts as guesses, not facts. Your mind is trying to predict what might happen, but it might be wildly out! Are you basing your predictions on what happened in exactly the same situation in the past? And if so, how likely is it that every factor will be exactly the same? (The philosopher Heraclitus famously said that “we never step into the same river twice”.)
  • Remember that just as our muscles are there to allow us to stretch and move, the brain is there to produce thoughts. Some of these are useful, and some are less so, while others are not useful at all. Spend some time when you’re not anxious just noticing some of the thoughts that arise in your mind. Perhaps think of them as clouds passing by, in front of your awareness – you can pick one or two up, or choose to let them all just float on by. There’s no need to act or even react to our thoughts – noticing them in a detached way allows us time to evaluate their usefulness and respond with choice.
  • Be aware that the mind can also make up whole stories, especially about ourselves (perhaps that we are unlovable or worthless or ‘stupid’). These messages are likely to have evolved from past experiences, and do not necessarily bear any relation to any truths about ourselves. If you have had difficult relationships in the past – with family members, friends or work colleagues, for instance – it’s possible that you’ve picked up faulty information (this is a useful area to explore in counselling). Notice any thoughts or stories like this and allow them to float on by. If they’re ‘sticky’, write them down or draw something that represents them. That way they have been expressed, and you can always come back to them later.
  • Broaden the picture. It’s possible to become very drawn to one particular aspect of a situation and become scared by that. Broaden your view, so that when you consider the situation again, it’s just one part of a much larger picture in your mind. If you like, you can ‘zoom out’ all the way to a satellite view of earth. Or imagine how you’ll think about this situation in 10 years’ time. Give yourself more distance, either geographically or in time. How big does the problem seem now?
  • Stay in the present. Look around you now, and notice the colours, sounds and shapes. What’s moving? What’s still? Are there any smells? Is any part of your body touching the ground or a piece of furniture? How is it, being in this body, today, here and now?

CALMING THE BODY

Here are a few effective ways of calming the body (the mind will follow!)

  • Reduce caffeine intake to 300 mg or less per day (that’s two cups of filtered coffee or three cups of instant)
  • Do some physical exercise every day for at least 30 minutes (even a brisk walk will do, but a run is even better)
  • Spend time doing things you love – make sure you’ve got room in your weekly schedule for fun stuff
  • Practise breathing exercises when you’re feeling anxious and just at occasional times during the day. Breathe gently in, drawing the breath down to your lower abdomen (as though you’re blowing up a balloon in your belly), hold the breath for a count of three, and then gently breathe out of your mouth as slowly as possible. Try to make the out-breath at least twice as long as the in-breath. Don’t gulp in the air, because that can cause the physical symptoms of panic. Take it slow, and focus on the slow out-breath. Repeat at least three times whenever you want to calm the mind and body.
  • Everyone has personal favourites (or ‘tools’) too, which they can use to restore balance to the body and mind, such as music, reading, dancing or swimming.

Lastly, it may be that anxiety has a unique meaning for you and actually does ‘make sense’ in a way that you haven’t yet realised. Once this is known, you have a very powerful way of reducing anxiety or even banishing it forever. I’ll look at this in my next post.

As always, thanks for reading.

Sarah Tomley is a counsellor working in Suffolk, UK (www.insightcounsellingipswich.com)

Test your own anxiety levels

Anxiety is a natural thing. Not only that, it’s essential – without anxiety we probably wouldn’t bother doing anything or even survive. Anixety is a motivator, that reminds us that there’s stuff to do, as well as a survival instinct that keeps us safe in dangerous situations. However, when anxiety begins to become an almost ever-present state of being, it can affect our wellbeing and increasingly encroach on our everyday lives, causing us to avoid anything that threatens to bring on an anxious feeling.

An anxiety disorder is said to exist when anxiety becomes long-lasting and severe, and affects a person’s work or relationships.  In 1988, Sir David Goldberg and colleagues at the Social Psychiatry Research Unit within the Australian National University came up with a ‘scale’ or set of questions that could be used to test anxiety levels. It’s simple and quick – so if you’d like to see whereabouts you sit on the scale, read the following questions and write down an answer (‘yes’ or ‘no’) for each question on a piece of paper.

The Goldberg Anxiety Scale
In the past month, for most of the time:

  1. Have you felt keyed up, high-strung or on edge?
  2. Have you been worrying a lot?
  3. Have you been irritable?
  4. Have you had any difficulty relaxing?
  5. Have you been sleeping poorly? (too much or too little)
  6. Have you had headaches or neck-aches?
  7. Have you had any of the following: trembling, tingling, dizzy spells, sweating, frequent urination, or diarrhoea?
  8. Have you been worried about your health?
  9. Have you had difficulty falling asleep?

Interpretating the test
Score one point for each ‘yes’. Most people have some of these symptoms – the average score for the test is four – but the higher the score, the more likely you are to be experiencing anxiety at a level that is affecting and disrupting your life. It may be that you are aware of an event in your life that has caused temporary anxiety, and that you feel the fog is lifting. But if you are troubled by some of the symptoms, and have noticed they are beginning to affect your ability to function on a daily level, this may be a good time to seek professional help from your doctor and consider counselling. Many people seek help for anxiety, because it responds to all sorts of treatments, from simple self-help strategies to counselling and  short-term medication. It is not a ‘character flaw’ or ‘weakness’, but a natural instinct that sometimes runs on overtime, especially when we’re trying to take on especially challenging responsibilities.

In my next post I’ll list some effective self-help strategies for reducing anxiety, including ways to calm the body and mind. As always, thanks for reading.

Sarah Tomley is a counsellor and author working in Suffolk, UK at Insight Counselling Ipswich

What is Generalised Anxiety Disorder (GAD)?

Everyone experiences anxiety from time to time, but sometimes it can begin to take over a person’s life. Generalised Anxiety Disorder (GAD) is characterised by a constant state of high anxiety that has continued for at least six months.
It is relatively common and is also known as ‘chronic worrying’ or ‘free-floating anxiety’, because it continues regardless of the reality of everyday life. People with GAD may find themselves worrying about daily issues such as work, health, money or relationships to an excessive degree, and be filled with a horrible sense that something very bad is going to happen. GAD can affect daily functioning in physical, mental and emotional ways, and make life increasingly difficult, as tension, fatigue and lack of sleep begin to increase the level of the worry cycle.
How anxiety differs from fear
Unlike fear, which is a response to an event, anxiety is worry about events that may occur in the future; it is an emotional state produced not by events in the external world, but by worry in the person’s mind. This is the bad and the good news: because it is fear of the future, it can be seen as potentially present all the time. On the other hand, because it is an emotional state produced by the mind, it will disappear if the emotional state ceases to create it. People with GAD may have evolved strategies for managing the anxiety; most often they prevent themselves from entering situations that could provoke anxiety by using ‘avoidant strategies’ such as distraction, excessive preparation (such as arriving very early for appointments) constant checking (that a door is locked, for instance), and procrastination (putting things off that need to be done). However, by avoiding these situations, they may be inadvertently causing the anxiety to grow, because the sense of dread and worry increases each time the feared situation is avoided.
Key symptoms
There are five main symptoms of GAD:
  1. A constant feeling of being ‘on edge’ or ‘keyed up’ which manifests as irritability and jumpiness
  2. Muscular tension
  3. Continual fatigue
  4. A tendency for the mind to ‘go blank’ and a lack of concentration
  5. Sleep problems, such as difficulty falling or staying asleep.

Other symptoms can also arise, such as impatience, feeling over-sensitive and reactive, loss of appetite, nausea, excessive urination, shallow, rapid breathing, palpitations, feeling faint, and experiencing a sense of dread or panic.

On a cognitive level, people with GAD have a tendency to ‘catastrophize’ and may find that they are expecting the worst possible scenario to emerge from situations. Confidence in problem-solving can take a dive, and decision-making can become difficult. They may also find themselves feeling hyper-alert to threatening stimuli and interpreting ambiguous situations as threatening.

Psychotherapy for GAD

Some therapies, such as cognitive behavioural therapy (CBT) focus on the perceptual biases that cause the negative thoughts and expectations, and CBT has been found to help reduce these thoughts and responses. However, when challenges to thinking patterns are combined with a therapy that also looks at emotional reactions and learned behaviour from past situations, new learning can take place at a deeper level, preventing a reaction from taking place, rather than managing an arising reaction. Recently, therapies such as Emotional Coherence therapy have suggested that anxiety can stem from a positive attempt to keep an important, learned code of behaviour in place, which may no longer be in the person’s best interest and so creates internal conflict and anxiety. Find out more about how anxiety can be serving a real but unconscious process here.
 As always, thanks for reading.
Sarah Tomley is a counsellor working in Suffolk, UK, at Insight Counselling Ipswich

Should I have therapy?

In Spring 2014, The Huffington Post published an article on the ‘Eight signs you should see a therapist’. This sounds a little dictatorial, because no one (and certainly no newspaper!) has the right to say that someone ‘should’ see a therapist. There are no rules about seeing a therapist, and in fact one of the things people find most useful about therapy is the complete lack of ‘shoulds’ – there is no right or wrong way to do it, and no perfect person to ‘be’. The therapy hour is a unique space in that respect: this is a place where people are valued, respected, and free to talk about whatever they wish, at a pace that feels right to them, in a space that is calm and confidential.

There are many reasons that people seek help through some form of therapy. Problematic situations or difficult emotions may loom large or seem acutely pinpointed. People visiting a therapist may be feeling overwhelmed, anxious or depressed, or worried about feeling nothing at all. They may be wrestling with relationship problems, looking for ways to cope with chronic pain or simply feeling irretrievably ‘stuck’ in a painful place,for reasons known or unknown.

As author Scott Peck said, way back in 1978, ‘Life is difficult’, and sometimes our coping methods and support systems aren’t able to carry us through. When daily life becomes a struggle, sometimes therapy can help.

And those ‘eight signs’? They’re here, along with my suggestions of what someone might wish for in their place:

  • You have unexplained and recurrent headaches, stomach-aches or a rundown immune system (you want to feel physically better)
  • You’re using a substance to cope (you want to be able to feel good without self-medicating)
  • You’re getting bad feedback at work (you want to achieve more and feel good about yourself at work)
  • You feel disconnected from previously beloved activities (you want to feel joy as you go about your life)
  • Your relationships are strained (you want your relationships to be rich and fulfilling)
  • You’ve suffered a trauma and you can’t seem to stop thinking about it (you want to find a way to deal with a past event so that you feel peaceful and easy once more)
  • Everything you feel is intense (you want more balance in your life)
  • Your friends have told you they’re concerned (you want time and a place to work things out for yourself)

These are all good reasons for considering therapy. As are these:

  • The wish to find a way to forgive others, or yourself
  • The desire to stop feeling like you’re on ‘autopilot’
  • The wish to turn an ok marriage into a great one
  • The desire to find a different way of parenting
  • The desire to find out what you really want from life

Therapy isn’t a cure-all, but it is a safe place to work out what’s happening now, where you’ve been, where you’re going, and where you want to go. In your own time.

Here’s that Huff Post article in full:

http://www.huffingtonpost.com/2014/02/12/8-signs-you-should-see-a_n_4718245.html

Sarah Tomley is a counsellor working in Suffolk, UK, at Insight Counselling Ipswich.