The commonest illness on earth that turns lives into misery. Yet in many cases, we can make a huge contribution to our own recovery.
At various stages in the last 56 years, I, like most people, have been prone to anxiety.
In my case, facing a dreadful crisis at one point in my life, it tipped over into full-blown Obsessional Compulsive Disorder and Depression. (Search for either of those terms on this blog for more information.)
Nowadays, perhaps with the benefit of middle aged perspective, (the clear realisation that one will survive most things and come out stronger, given time, and therefore it can be excellent practice to just to try and “roll with the punches” – indeed, the greatest gift of middle age is patience) I am less likely to fall prone to the misery of anxiety.
Perhaps, also, my brain chemistry is more stable, (it is notoriously less so for teenagers and young adults), or I have just learned to recognise anxiety faster, and deal with it more effectively.
In any event, now that I have taken the decision to be open about my own brushes with “mental illness” (which should, of course, be called “physical illness affecting the brain” – I am no more “nuts” than the next person) I am constantly meeting other people who struggle with anxiety disorders of one sort or another, and who often ask my advice when I pipe up about them.
Sadly, I am not an expert.
Or rather, I am expert in what the bloody illness feels like, but not really an expert in how to solve it.
What worked for me, or someone else, might not work for you. So I went looking for some help online, and found this excellent article from the Australian National University, which is well worth a read.
I have made the occasional comment myself in italics. The rest is from ANU. It’s chock full of good commonsense.
I hope you, or someone you know, finds it helpful.
The 10 best ever anxiety management techniques
These techniques fall into three typical clusters:
- the physical arousal that constitutes the terror of panic
- the ‘wired’ feelings of tension that correlate with being ‘stressed out’
- the mental anguish of rumination – a brain that won’t stop thinking distressing thoughts
Cluster One: Physical Arousal
Distressing Physical Arousal – sympathetic arousal causes the heart thumping, pulse-racing, dizzy, tingly, shortness of breath physical symptoms, that can come out of the blue and are intolerable when not understood.
Even low levels of anxiety can cause physical tension in the jaw, neck and back as well as an emotional somatic feeling of doom or dread in the pit of the stomach, which will set off a mental search for what might be causing it.
Method 1: Manage your body.
- Eat right
- Avoid alcohol, nicotine, sugar and caffeine
Certainly in excess. The temptation to self-medicate with alcohol particularly is a curse for those who suffer from anxiety, because it is an utterly transitory solution. As soon as the buzz wears off, one is just as (or often more) depressed, and now dealing with a hangover as well.The most intelligent comment I have ever heard about booze was “I used to drink to drown my sorrows. Then one day I woke up and discovered they’d learned how to swim.” However, in my experience, one or two drinks, especially in the late afternoon or early evening, can be helpful in “switching off” the day and settling down for an evening’s relaxation and a night’s rest. I am also advised that a good session on a treadmill in the spare room or at the gym has a similar relaxing effect.
- On going self care
This needs to be active and deliberate. Looking after yourself is often the lowest priority for people with anxiety or depression. It should be the first.
I always rely on the rule “an hour before midnight is worth two after”. I have no idea if that has any scientific basis, but it’s true for me. Similarly, sleeping at the wrong time of the day (eg during daylight hours) can leave one with a sense of worthlessness, or having “wasted time”. That said, I think I am convinced that a short “Nanna Nap” (eg 30-60 mins) in the mid-late afternoon can be health-enhancing and lead to more productive evenings.
- Consider hormonal changes
Method 2: Breathe
Breathing deeply and being aware of the process will slow down or stop the stress response.
I don’t know why this simple fact is so hard for stressed people to get hold of. Close your eyes. Decide to ignore, momentarily at least, whatever is troubling you. Breathe in, hold the breath momentarily, breathe out through your mouth. Empty your lungs. Repeat. Do it for 60 seconds and you can feel control of your emotions returning. It’s infallible.
Do the conscious, deep breathing for about 1 minute at a time, and do it when you are not stressed, at least 10-15 times per day – just do it every time you are waiting for something eg., the phone to ring, an appointment, the kettle to boil, waiting in a line etc.
Method 3: Mindful Awareness
Close your eyes and breathe; notice the body, how the intake of air feels, how the heart beats, what you can feel in the gut.
Breathe. Just breathe.
- With eyes still closed, purposefully shift your awareness away from your body to everything you can hear or smell or feel through your skin
- Shift awareness back and forth from your body to what’s going on around you
You will learn in a physical way that you can control what aspects of the world – internal or external – you’ll notice, giving you an internal locus of control and learning that when you can ignore physical sensations, you can overcome them.
Above all, resist the temptation to make catastrophic interpretations of events that bring on panic or worry. Keeping things “in perspective” allows you to feel more in control and mindful of the present.
Very few things are catastrophic in life, and even catastrophic things can be overcome.
Just decide to stop “blowing things out of proportion”.
Stop luxuriating in fear.
It isn’t good for you, and it never solves the problem.
Cluster Two: Tension, Stress and Dread
Many people with anxiety search frantically for the reasons behind their symptoms in the hope that they can ‘solve’ whatever problem it is,
But since much of their heightened tension isn’t about a real problem, they are actually wasting their time running around an inner maze of perpetual worry.
Even if the tension stems from psychological or other causes, there are ways to eliminate the symptoms of worry.
These methods are most helpful for diminishing chronic tension.
Method 4: Don’t listen when worry calls your name
This feeling of dread and tension comprises a state of low grade fear, which can also cause other physical symptoms, like headache, joint pain and ulcers. The feeling of dread is just the emotional manifestation of physical tension.
You must first learn that worry is a habit with a neurobiological underpinning. Then apply relaxation to counteract the tension that is building up.
Nothing real is causing it, so get rid of the symptoms, and enjoy life without them.
This ‘Don’t Listen’ method decreases the tension by combining a decision to simply ignore the voice of worry with a cue for the relaxation state.
To stop listening to the command to worry, you can say to yourself: “This is just my anxious brain firing wrong”. This is the cue to begin relaxation breathing (as described earlier) which will stop the physical sensations of dread that trigger the radar.
Method 5: Knowing, Not Showing, Anger
When you fear anger because of past experience, (which may be very real, and justified) the very feeling of anger, even though it remains unconscious, can produce anxiety, which does no good to you at all. To know you’re angry doesn’t require you to show you’re angry.
A simple technique: Next time you feel stricken with anxiety, you should sit down and write as many answers as possible to this question, “If I were angry, what might I be angry about?” Restrict answers to single words or brief phrases.
This may open the door to get some insight into the connection between your anger and your anxiety.
Method 6: Have a Little Fun
Laughing is a great way to increase good feelings and discharge tension. Getting in touch with fun and play isn’t easy for the serious, tense worrier.
A therapy goal could be simply to re-learn what you had fun doing in the past and prescribe yourself some fun.
In my experience, this can involve choosing to be around people who are fun, and spending less time with people who “bring you down”. When you are more on an even keel, you can deal with less cheerful people more easily. In the meantime, there’s good reason to avoid them. Seek out positive, gentle, funny people.
Cluster Three: The Mental Anguish of Rumination
These methods deal with the difficult problem of a brain that won’t stop thinking about distressing thoughts or where worry suffocates your mental and emotional life. These worries hum along in the background, generating tension or sick feelings, destroying concentration and diminishing the capacity to pay attention to the good things in life.
Therapy does not need to focus on any specific worry, but rather on the act of worrying itself – the following methods are the most effective in eliminating rumination.
Method 7: Turning it Off
If a ruminating brain is like an engine stuck in gear and over-heating, then slowing or stopping it gives it a chance to cool off. The goal of ‘turning it off’ is to give the ruminative mind a chance to rest and calm down.
Sit quietly with eyes closed and focus on an image of an open container ready to receive every issue on your mind. See and name each issue or worry and imagine putting it into the container.
When no more issues come to mind, ‘put a lid’ on the container and place it on a shelf or in some other out of the way place until you need to go back to get something from it.
Once you have the container on the shelf, you invite into the space that is left in your mind whatever is the most important current thought or feeling.
At night, right before sleep, invite in a peaceful or happy thought to focus on while drifting off.
Method 8: Persistent Interruption of Rumination
Ruminative worry has a life of its own, consistently interfering with every other thought in your mind.
The key to changing this pattern is to be persistent with your attempts to use thought stopping and thought replacement. Its important to attempt to interrupt the pattern every time you catch yourself ruminating – be aware that you’ve spent a long time establishing this pattern and it will take persistence to wear it down.
Work on having a good five minutes without worry … then another .. then a day … and so on. Be patient. Change takes time.
Thought stopping – use the command “Stop” and/or a visual image to remind yourself that you are going into an old thinking habit that just leaves you feeling uptight.
Thought replacement – substitute a reassuring, assertive or self-accepting statement after you have managed to stop the thought. You may need to develop a set of these statements that you can look at or recall from memory.
Method 9: Worry Well, but Only Once
Some worries just have to be faced head-on, and worrying about them the right way can help eliminate secondary, unnecessary worrying. When you feel that your worries are out of control try this next method:
- Worry through all the issues within a time limit of 10-20 mins and cover all the bases
- Do anything that must be done at the present time. Set a time when it’ll be necessary to think about the worry again.
- Write that time on a calendar.
- Whenever the thought pops up again say, “Stop! I already worried!” and divert your thoughts as quickly as possible to another activity – you may need to make a list of these possible diversions beforehand. Until it’s time to tackle the issue again, forget it.
You may find, in the meantime, it quietly resolves itself.
Method 10: Learn to Plan Instead of Worry
A big difference between planning and worrying is that a good plan doesn’t need constant review.
An anxious brain, however, will reconsider a plan over and over to be sure it’s the right plan.
This is all just ruminating worry disguising itself as making a plan and then seeking constant reassurance.
It is important to learn the fundamentals of planning as it can make a big difference in calming a ruminative mind. These include:
- Concretely identifying the problem
- Listing the problem solving options
- Picking one of the options
- Writing out a plan of action
Fail to plan, and you plan to fail. Never was a truer word spoken, and especially for people who are inclined to be anxious.
To be successful in this approach, you must also have learned to apply the thought-stopping/thought-replacing tools or you can turn planning into endless cycles of re-planning.
Once a plan has been made you can use the fact that you have the plan as a concrete reassurance to prevent the round-robin of ruminative re-planning.
The plan becomes part of the thought-stopping statement:
“Stop! I have a plan!”
It also helps the endless reassurance-seeking, because it provides written solutions even to problems the ruminator considers hopelessly complex.
These skills do require patience and determination. However, once learnt, people gain a lasting sense of their own power and competence in working actively with their own symptoms to conquer anxiety through their own efforts.
Getting control of yourself. It’s a wonderfully liberating feeling. Good luck!