Anxiety is the body's natural reaction to stress. Everyone feels anxious at certain times of danger or in worrying situations. In some circumstances anxiety is useful. It prepares you for action and enables you to respond quickly if necessary. Moderate amounts of anxiety can improve your performance. However when it interferes with everyday life, e.g. it may occur too frequently, in the wrong situations, or the symptoms become too strong so that they stop you from doing things you want.
There is usually a combination of causes why anxiety may become more difficult to control. If you are under a lot of stress you may be more vulnerable to anxiety. Some people are more sensitive to stress than others and they may feel anxious more quickly or take a longer time to calm down. Some people learn from early experiences how to get anxious and how to worry, e.g. if we saw our parents being anxious in situations as children. In these circumstances we learn to be anxious when there is no real danger. This occurs by us misinterpreting events as stressful when they are not. The body has no way of knowing this. It relies on our brain telling our bodies whether a stressful situation is real or not. When a person begins to get anxious, his thoughts will affect whether we continue to feel anxious or whether we begin to relax.
Increased anxiety can be very difficult to deal with and we may end up resorting to unhealthy coping mechanisms e.g. increased alcohol use, overeating avoiding situations. These coping methods do not allow us to relearn how to control anxiety and can actually maintain or even make it worse. In the long term we may feel depressed, lonely because we are unable to face any difficult situation.
What can we do to cope with anxiety?
We need to recognise how anxiety affects us and understand how anxiety is maintained. We then need to learn new ways of dealing with:
Physical Symptoms : i.e. bodily sensations
Behaviour : i.e. what we do when we are anxious.
Thoughts : i.e. what we think and tell ourselves when we are feeling anxious.
We have to work on all the above in order to learn to control our anxiety.
The Physical Symptoms of Anxiety
When we feel anxious a chain of automatic events occurs in our bodies which prepares us for action. This reaction is called the Flight or Fight response i.e. either to run away from the danger or to stand and fight it.
The reaction consists of the brain sending a message to pump a hormone called adrenalin into the blood stream and muscles of the arms and legs. The heart beats faster as it works harder to pump the blood and adrenalin around the body and this can cause palpitations and increased blood pressure. We breathe more quickly as the lungs are having to work harder, we generate more heat so our skin looks red and we sweat more to cool down. Our muscles become more tense causing aching muscles and tiredness, our mouth becomes dry and there may be difficulty in swallowing. Our digestion slows down as the blood is diverted away from the stomach to the large muscles and this may cause sickness, indigestion, butterflies. The body needs to be as light as possible so it gets rid of waste products causing the need to go to the toilet. The release of adrenaline and increased blood pressure causes headaches and dizziness.
When this chain of events occurs in everyday situations it can be very frightening. Often, when people feel anxious a lot of the time they begin to worry about the symptoms themselves and believe that they may be dying or developing a serious illness. This means that we get more anxious and the symptoms feel worse setting up a vicious cycle. It is important to remember that symptoms are natural and not harmful and that the body will gradually slow down and the symptoms will go. You can learn to have more control of these symptoms through relaxation.
Choose somewhere quiet, where you won't be disturbed. Make sure you are warm and comfortable. Allow yourself to completely relax all the muscles in your body. Clench and unclench all the muscles starting from your toes and working your way up while breathing deeply and slowly. At the same time try to create a relaxing picture in your mind - lying on the beach, walking through the countryside, whatever works for you. Try to keep that image in your mind while you relax your whole body. Try and build this into your daily routine - take time out to relax and let go of your worries and fears.
Behavioural Consequences of Anxiety
The most common behavioural consequence when we feel anxious is avoiding situations which makes us feel anxious - this may be being in a room with lots of people, going into crowded shops, standing in queues, going into a lift. Sometimes people try and cope in other ways, drinking, drugs, or violence and sometimes by developing obsessional behavioural patterns e.g. over washing, checking and rechecking things. In reality the only way to overcome and lessen anxiety is to meet it and try and stay in the situation a bit longer each time.
How to Control our Thoughts
Anticipating Anxiety - sometimes we worry about something that hasn't happened. Sometimes we can become anxious just thinking about some future task or event and this can become unpleasant and we end up avoiding the situation. We may tell ourselves:
- I know I will feel terrible when I go out/do this, I can't.
- People will look at me, laugh at me when I do this.
- Something bad will happen if don't do this.
- I always have to have a drink before I can do this.
- I know it will go wrong as it always does.
Notice that a lot of the words being used are very definite and rigid, e.g. will, have to, always, can't - these words encourage us to look negatively at a situation and do not allow for any hope or possibility of change.
Remember we have a choice, although we may not be able to change a situation, we can change how we look at it. One view can create a low mood or anxiety while another may make us feel great and more encouraged.
Suggestions : Avoid always, ever, must, should, have to, never, can't etc.
Try : maybe, possibility, hopefully, sometimes, perhaps etc.
Thoughts : can play an important part in keeping anxiety going or even making it worse. If you forget that it is only anxiety and start thinking I am going to have a heart attack, or collapse, then this is likely to increase the level of anxiety.
Challenge : these or any other negative thoughts you have by choosing other possible, less upsetting view points and give yourself time to begin breathing exercise, relaxation, distraction methods. Remember to give yourself credit for all that you do no matter how small it seems, in this way you can encourage yourself to continue to stay in the situation a bit longer try things you have avoided a little at a time and give yourself the support you need to practice all you have learned.
The principle ideas behind distraction in anxiety control are:
- It is very difficult to concentrate on two things at once.
- Relaxation and anxiety are incompatible i.e. you cannot be both relaxed and anxious at the same time.
This means that if we learn to stop concentrating on being anxious and begin to concentrate on something else a more relaxed state will begin to replace the anxious one.
We need to learn to distract our thoughts. Often it is what we are thinking which causes anxiety, help keep it going or makes it worse.
Recognition : Become aware of your thoughts. Write down some of the thoughts you have experienced before, during and after anxious times.
Thought Stopping : Every time you recognise a thought which is unhelpful say STOP to yourself. You can combine this with pinging a rubber band around your wrist or pinching yourself which can help change the direction of your thoughts.
Positive Imagery : Try to think about something else other than the physical symptoms or worrying that we will become anxious. Practice concentrating on a pleasant past experience, really focus on this in detail.
Some questions you can ask yourself to keep your mind on this:
- What was the weather like?
- Where did it happen?
- Who was there?
- What were they wearing?
- Exactly what did everyone say or do?
- How did I feel?
- What did I like about it?
Mental Games : Doing puzzles, crosswords, word games, reciting a poem, singing a song, counting backwards from 100, are all useful distraction exercises.
External Focus : Concentrating on a specific detail of the world around you, for example, making words out of number plates of cars or guessing what people do for a living. Focusing on the outside world will prevent you thinking about what is going on inside.
Challenge Thoughts : Every time we notice that our thoughts are upsetting or negative, think up a more positive alternative, talk to yourself in a positive way and give yourself encouragement.
Relaxation : Listen to some music or a relaxation tape, if you have a walkman you can do this anywhere. You can use whatever method of relaxation that works for you to help you to switch off the worrying thoughts. As with most techniques it may take a while to get used to them. It is important to practice these techniques so that you feel comfortable with them.
Resources: West Lambeth Community Care Trust
If you find yourself constantly worrying about things which are coming up in the future, try and remember that all the worry in the world won't change anything. You are wasting energy and time worrying when that energy and time could be used to go out and enjoy yourself. When you start worrying about something try and train yourself to say 'I'm not going to worry about this now and I will deal with it when the time comes'.
If you are a worrier and find that you are continually getting anxious about things and this is preventing you from getting on with your work or other things you need to do, some people find that it can work if you allow yourself a worry hour. Choose a time each day (say 6pm-7pm) which you designate as your worry hour. During that time you allow yourself to think about all the things which are worrying you. However if during the day you find you start worrying about something say to yourself 'no, I'm not going to think about that now, I'll think about that later in myworry hour'. This can be effective in stopping you from spending the whole day worrying about things - when your worry hour is over as soon as an anxious thought comes into your mind tell yourself you will think about that in your worry hour the next day. This is giving yourself permission to worry about things but only in a set time - You may find that by doing this technique for a while that you find it helps you to be less anxious and to worry less and that the anxiety should not affect your whole day and evening.
Some organisations which may be useful to you
Anxiety UK (formerly National Phobics Society):
03444 775 774,
www.anxietyuk.org.uk - Helps all those suffering with anxiety disorders. Self help leaflets and contact lists. Self help groups, counselling, phone self help groups, email support.
Farming Community Network (FCN):
03000 111 999
Confidential listening and signposting service for the farming community.
International Stress Management Association:
To provide information about all aspects of stress management. Provide support and run conferences and workshops, leaflets.
0808 808 8000
For anyone in N.Ireland who is in distress or despair. Immediate help on phone 24 hours a day 7 days a week. Face to face counselling can be arranged, also befriending, mentoring. Issues dealt with include suicide prevention, self harm, abuse, trauma, depression, anxiety.
Breathing Space - Living Life - (covering Scotland)
0800 83 85 87
Available in Scotland
Breathing Space is a free telephone service offering guided self help and cognitive behaviour therapy. The service is available to anyone over the age of 16 who is suffering from low mood, mild to moderate depression and/or anxiety.
Helpline: 0844 9674848
Youth Helpline 0330 606 1174 (for 13 to 20 year olds open Mon to Thurs 4pm-6pm)
Helpline for anxiety disorders, panic attacks etc. Provides advice, counselling, listening, befriending and can make referrals. Local self help groups and produces leaflets, audio and video cassettes.
OCD Action: 0845 390 6232, www.ocdaction.org.uk - Information and support for Obsessive Compulsive Disorders (OCDs) and related disorders including Body Dismorphic Disorder (BDD), Skin Picking (CSP), Trichotillomania (TTM) – compulsive hair pulling.
OCD-UK: www.ocduk.org - Information and support relating to OCDs. Also information relating to local support groups.
SA-UK (Social Anxiety UK): www.social-anxiety.org.uk Volunteer led organisation, news, advice, info, meetings, chatroom, forums, support/social groups, info on cognitive behavioural therapy.
In its simplest terms social anxiety or 'SA' is a fear of people, of being around, having to interact with, being watched, criticized or judged negatively by other human beings. For sufferers of SA everyday tasks which most people take for granted - working, socialising, shopping, speaking on the telephone, can be a wearing ordeal marked by persistent feelings of anxiety and self consciousness.
TOP UK (Triumph Over Phobia) - The OCD and Phobia Charity
UK registered charity which aims to help sufferers of phobias, obsessive compulsive disorder and other related anxiety to overcome their fears and become ex sufferers, run a network of self help therapy groups.
www.anxietynomore.co.uk - information and advice on all aspects of anxiety and panic.
An anonymous and safe professionally moderated community moderated 24/7
www.calmclinic.com - information relating to anxiety, panic disorder, stress and depression
www.dailystrength.org - Online community support for anxiety, mental health, and health related conditions.
Help and information for overcoming fear of the dentist
www.haveigotaproblem.com - free resource for mental health and addiction issues created and run by the Tasha Foundation.
www.healthyplace.com - Information and support for those suffering from anxiety (American site).
www.helpguide.org - put Stress in search bar at top of page
Cognitive Behavioural Therapy (CBT) has proven to be effective in treating anxiety, stress, depression and many other mental health problems. A course of online therapy treatment is free for many NHS patients in many areas of the UK.
HOPE - supporting anyone who is struggling with their mental health, if you are anxious or depressed, don't suffer in silence.
Selective Mutism Support and Advice
Oasis, the NHS Community Mental Health Team in London have developed this site which is aimed at young people 14-35 years who are struggling with unusual experiences like hearing voices or feeling paranoid. Although some of the contact information is relevant to the London Boroughs of Lambeth, Southwark, Croydon, or Lewisham, the general information provided would be helpful for anyone struggling with these issues.
Information relating to mental health, depression, stress and anxiety
information on how to cope with panic attacks
www.nomorepanic.co.uk - Information for sufferers of panic, anxiety, phobias and ocds. Includes chat room and message boards. Also information relating to insomnia.
www.stressbubbles.com - struggling with depression, anxiety, mental health, some great healing tips from someone who has suffered with these issues herself.
www.succeedsocially.com - Getting past social problems, how to meet new people and make friends and improve social skills.
Embracing the Fear: Learning To Manage Anxiety & Panic Attacks by Judith Bemis, Amr Barrada - Publishers Hazelden Information & Educational Services: ISBN 089486971X
Click here to read more or buy this book
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