“Nothing in the affairs of men is worthy of great anxiety.” – Plato

managing-anxietyBefore getting into the nitty gritty of anxiety as a topic, the good news is that anxiety is treatable.  It’s also reassuring somehow to know that everyone experiences feelings of anxiety, nervousness, tension and stress from time to time.

Anxiety takes on many forms under the heading of Anxiety Disorders and the common theme in all is that it impacts on a person’s day to day activities.  Anxiety can affect your ability to sleep, concentrate, and carry out day to day tasks at work, home, school or socially.  As a consequence, you may find yourself compelled to avoid stressful situations and in extreme situations avoiding going out altogether.  Physical symptoms may include shortness of breath, trembling, shaking hands, pounding heart, dryness of the mouth, excessive perspiration etc.

Just to show how diverse the range of anxiety disorders can be we’ll quickly look at the six most common types…

  • Generalised Anxiety Disorder – Excessive, uncontrollable worry about a vast range of ordinary daily situations such as work, health or finances.
  • Panic Disorder – In association with regular panic attacks there are sudden intense episodes of irrational fear, dizziness, shortness of breath, feeling out of control, palpitations, choking, and various other physical symptoms.
  • Social Anxiety Disorder also known as Social Phobia – Avoidance of social or performance situations due to fear of being rejected, judged or embarrassed.
  • Post Traumatic Stress Disorder – As a result of witnessing or experiencing a traumatic life event, feelings of fear or avoidance continue to remain.
  • Agoraphobia –Often associated with Panic Disorder, agoraphobia involves avoidance of situations that may trigger the fear of having a panic attack.
  • Obsessive Compulsive Disorder – Involves impulses (obsessions) and unwanted thoughts which lead to repetitive routine behaviours (compulsions) as a way of coping with feelings of anxiety.
  • Specific Phobias – Irrational fears displayed in a particular situation, such as fear of being confined or exposure to open spaces, people, animals, insects.

Other symptoms of Anxiety:
Physical: Pounding heart, increased heart beat, rapid breathing or shortness of breath, dizziness, choking, sweating, trembling, tiredness, listlessness, feelings of physical weakness, blushing, diarrhoea, sleep disturbances, nightmares, muscle tension and headaches.

Emotional: Loss of concentration and remembering, sense of panic/danger/doom, racing mind and thoughts, difficulty with memory, feelings of powerlessness.

Social: Loss of confidence, isolation, increased dependence on specific persons, disengagement from life/loss of social network contacts.

Causes of Anxiety:
May include….

  • Ongoing stressful situations – joblessness, changes in employment, family conflict, relationship breakdown, loss and grief, abuse (physical/sexual/ psychological), bullying, discrimination, life threatening events, violence, pregnancy and childbirth, parenting, carer’s responsibilities, financial debt,  lack of support, and homelessness.
  • Physical health issues – the precipitating factors include underlying health issues such as diabetes, asthma, thyroid problems, heart disease, hormone function/fluctuations.  Anxiety may be a precursor to physical health concerns.  Sudden illnesses, diagnosis leading to hospitalisation, ongoing treatment, and disability.
  • Personality traits – such as needing to be in control, perfectionism, and low self esteem may make people more susceptible to anxiety.
  • Drug/substance abuse – in particular cannabis, amphetamines, sedatives and alcohol which can trigger anxiety symptoms. The process of sudden and monitored drug and alcohol withdrawal may also cause withdrawal-related anxiety.

Treatments for Anxiety:
Treatments depend on the type of anxiety disorder being experienced.  In the case of mild anxiety, strategies may include changes to lifestyle.  Where the anxiety is more severe therapy and medication may be required.
Therapies may include… 
Cognitive Behaviour therapy – focusing on thought patterns.
Relaxation and Breathing techniques – addressing physical symptoms.  May include Mindfulness, Yoga, Tai Chi, and Asian Eastern philosophies/therapeutic approaches.
Medication – Using therapeutic approaches/therapies in conjunction with the use of  anti depressants.

20 Tips on Managing Anxiety

1.    Work with your body.
Your body will tell you when it is experiencing anxiety and your mind will carry out a mental search of the causes of these sensations.  Check where the physical tension is being felt.  Is it in the back, neck, jaw, stomach, shoulders?  What is happening to you this very minute?  Why now? What has brought about these physical responses?  Name the physical responses to your anxiety.

2.    Breathe.
Again, listen to what your body is saying.  Breathe slowly and deeply.  Calm your mind and focus on your breathing.  If you are experiencing rapid breath, focus on slowing down your breathing…start with a slow deep breath inhaling counting from one to three, exhaling one to three, repeat but lengthen the time from three to four then to five.   Change the scenery, for example look out into the garden, or find a room with a view.  If that is not possible then close your eyes and visualise being in a still, quiet place near the water.   It also helps to wriggle your toes and move your hands as though your fingers were making soft stroking movements in the water.

“There are moments when all anxiety and stated toil are becalmed in the infinite leisure and repose of nature.”
– Henry David Thoreau

3.    Learning to relax takes practice.
For most of us we all think we know how to relax which wrongly includes the practice of watching TV or working at the computer.  To relax we need to still the mind.  Using breathing techniques we create a calm channel between the diaphragm and the brain.  There is also the myth that alcohol, drugs or tobacco will relieve anxiety or stress.  On the contrary these are addictive practices which are doing your body and mind no favours.  It may be considered the quick fix but it doesn’t resolve the situation.
Close your eyes, using deep breathing, purposefully shift your awareness away from your body.  What can you feel, hear and smell.  Is the wind blowing gently against your face and skin?  Shift this awareness back and forth between your body and your surroundings – become a part of the world that surrounds you.

4.    Recognise and acknowledge the primal instinct.
All of us have basic human functions often referred to as primal instincts, hindbrain or reptilian brain.  The reptile bit refers more to the human brain that resembles a reptile’s brain.  This part of the brain has been with mankind for millions of years and in addition to fight, flight, freeze responses the very ancient part controls functions such as respiration and heartbeat.  Why is it important to recognise and acknowledge this very old part of us?  Because when you feel that knot in your stomach, the rapid breathing etc. you know it is a natural response to anxiety.  You are also in the position to use your intellectual, rational self to whack the reptilian brain on the head with a book and say something like “Would you just evolve, you overly dramatic creature.”  This strategy was employed by Therese Borchard (Assoc. Editor of Psych Central) and it’s a good one.

5.    Skip the dramatics…and change the scene.
While the unexamined life is not worth living, according to Seneca, there may also be an argument in favour of giving yourself a break.  It is time to get out of your head, create some distance and stop the ruminations by distracting yourself.  How about reading a good book, seeing a movie that you’ve wanted to see for ages (a comedy’s good) or catching up with some close friends for a bite to eat?  Maybe it’s time to take the dog for a walk.  He/she will be thrilled and show such gratitude for this kindness.

6.    Death to ruminations.
The ruminating brain has been described as being an engine stuck in gear and overheating.  It’s also seen by some as being a record with a crack in it which keeps playing the same music over and over again.  A good way to stop the thought process is to use the command “stop” and even use or visualise the hand gesture for stop as though you were a member of the Thought Police.   You may need to develop a set of self affirming statements to manage your thoughts.  An EFT (emotional freedom technique) is to say…”Even though I’m feeling anxious because ……….I truly and completed love and respect myself.”  There’s a lot of free information about EFT on the internet.

7.    Limit worry and cover all the bases.
In some cases, certain worries have to be faced head-on.  By thinking about them the right way you, can help eliminate ongoing, unnecessary worrying.
When you feel that your worries are out of control apply these strategies…
Cover all aspects of your worry and set a time limit of 15 minutes at least.
Reschedule a time on the calendar to review this worry. When the thought comes up again, say to yourself “Stop, I’ve already worried and I’m not going to spend more time on it now.”  Use your time more efficiently and divert your thoughts as quickly as possible to another activity.

8.    Overstate your greatest fear.
Now this may not seem a good idea at first glance, but for some people it has been known to work very effectively.  This tip was provided by a Beyond Blue reader who explained in a combox: “Tell your fear to someone else and make sure to be as dramatic as possible, with very descriptive words and emotions.  Then when you’ve told every detail you can think of, start over again.  Tell the entire dramatic story, again with very elaborate descriptions.  By the third or fourth time, it becomes a bit silly.”
I wouldn’t suggest telling the same person three or four times in a row, as you might just wear out your welcome.  But this strategy has some merit as it becomes a process of desensitisation.

9.    Air your grievances and worries in writing.
Write your concerns down and go into elaborate detail.  Really vent your spleen.  Write down every positive about the situation, then address the negative aspects.    Finally, try to make a case against moving forward. I’ll bet you’ve found a way to move forward rather than staying stuck.

10.    Take it minute to minute.
One way of relieving anxiety is to not get ahead of yourself. By using this cognitive adjustment, remind yourself that you don’t have to think about your next appointment, or when you pick up the kids or the issue you have with a friend or colleague.  Just stay in the present moment.  This way your day is accounted for in a more effective way.  Buddhists practice Mindfulness and find joy, gratitude and optimism in the present moment.  It really is about making time to ‘smell the roses.’

11.    Let’s get physical, physical….
The benefits of exercise can never be under-estimated.  The effect on your mind and body as a result of getting physical is that good endorphins flow which enhance mood and relieve anxiety.  Research has shown time and time again that exercise changes the brain.  By being active the brain produces more dopamine and serotonin, and the brain’s production of the growth hormone BDNF.  When we’re depressed the levels of this hormone plummet, so much so that parts of the brain begin to shrink over time, and learning and memory are impaired.  Thankfully, exercise helps to reverse this trend and protects the brain.  We don’t have to be into marathons to reap the benefits of exercise.  Walking, swimming, riding the bicycle, gardening – all of these will improve your wellbeing.

12.    Watching a movie of life’s events unfold.
Therapists who use practices grounded in Mindfulness and EMDR (Eye Movement Desensitization and Reprocessing) believe that clients can experience some relief from anxiety by gaining some distance from their thoughts, by learning to watch them as we would a movie.  Judgement is suspended and you go along for the entertainment, or to enjoy the scenery.
One technique that I find to be helpful is to see yourself in the carriage of a train and see the events that are causing the anxiety as a scene outside where you are watching from the safety of your seat.  By creating the ‘spectator’ rather than the ‘participator’ position, you gain a new perspective on issues that have led to the anxiety.  EMDR also uses eye movements to help alleviate anxiety symptoms.

13.    You’ve got to have a plan.
Where the mind constantly ruminates, a plan or course of action may be just what is needed.  The basic fundamentals include…
1.    Clearly identifying the problem
2.    List the problem solving options
3.    Select one of your options
4.    Construct (write out) a plan of action
The main thing is to stick with it and avoid endless cycles of replanning.  By using this technique the plan becomes a part of the thought stopping statement.  “Stop, I have a plan in place.”  It helps you stay grounded.

14.    Start getting into ‘mood foods.’
Often when anxiety starts to take a grip, there are telltale signs of poor dietary choices.  We all know the drill…restrict caffeine, cut out refined sugar, bad fats, processed flour; increase vegetable and fruit intake, more leafy greens, herbal teas, and water.  Makes sense doesn’t it?  There’s a lot of information available at Doctor’s surgeries, and on the internet.

15.    Heard of visual anchors?
Visual anchors are links with images/objects that bring you joy and calm the mind.  For example, if you love the water, use this image (and sound) to help you find the calmness you crave.  Perhaps you could download the sound of ‘ocean waves’ onto your iPod.   Other people may choose to look at a tree that comes into view, or the clouds.  Then, there are those who carry around a coin or medal that they hold when feeling anxious.  Have you noticed how worry beads are used by some people and are constantly in use?  It works for them.  A friend has a necklace with a cross attached, and when she’s feeling stressed or anxious, she will hold onto it until the anxiety passes.

16.    Positive Thinking.
A great way to ease your mind from anxiety is to focus your thoughts on things that are good, happy, beautiful and positive.  Give yourself permission to wish, dream, and imagine the best that could happen.  Practice being kind to yourself and to others.  Forgiveness is very strong and empowering and gives you permission to move on rather than stay stuck with past regrets.

17.    Connect with others.
It’s so important to spend time with friends and family.  By just hanging out with people you trust is beneficial to your health.  Doing things with those we feel close to deepens the bonds, offering support and security.  If anxiety starts to occur, confide in a friend who listens and cares, helps you feel more understood and makes you feel that you can cope after all.

“I’m going to love everything I do.” – Roo Stewart

18.    Sleep well, sweet dreams.
To enable your mind and body to feel peaceful and strong and with enough strength to handle life’s ups and downs, get the right amount of sleep for your needs – not too much or too little.  Once viewed only as symptoms, sleep problems may actually contribute to psychiatric disorders.  Insomnia may also be a risk factor for developing an anxiety disorder, but not as much as it is for major depression.  Neuro-imaging and neuro-chemistry studies suggest that a good night’s sleep helps foster mental and emotional resilience.  Lifestyle changes and the right medications as prescribed by your doctor are vital to nip this problem in the bud.

19.     Hereditary Factors and Personality.
Research has shown that some people with a family history of anxiety and depression are more likely (though not always) to also experience the same.
Do think about your family history and dynamics and what impact this may have on your well being.  It may be a good idea to discuss this with your doctor to rule out chemical imbalances in the brain regulating feelings and physical reactions.  Studies have also shown that certain personality types are more at risk of high anxiety than others.  People who have a tendency to be shy, who also have low self esteem and a poor capacity to cope are more likely to experience high levels of anxiety.  The positives here are that there are good practitioners available to help you on your road to recovery.

20.    Create your own mantra and maintain your sense of humour.
A mantra is your own declaration of life.  By reciting your mantra to yourself, it slowly changes the way you respond to challenges in your day.
Examples may include something like the following…

May I be filled with loving kindness
May I find the joy in all things
May I accept myself as I am in the present moment
May I accept others for their graciousness and failings
May all creatures and beings be free and live in peace

Finally, by flexing your funny bone and laughing daily, you do much more than relieve your anxiety.  Laughter and humour boost your immune system, reduce physical and psychological pain, heal wounds, fight viruses, and help build positive, sustainable relationships.  Laughter brings light into a room of shadows.

“Good humour is a tonic for mind and body.
It is the best antidote for anxiety and depression.
It is a business asset.
It attracts and keeps friends.
It lightens human burdens.
It is the direct route to serenity and contentment.”
– Grenville Kleiser