dealing with anxiety
what is anxiety?
Anxiety is a survival instinct that has evolved over millions of years in order to protect us. It is a series of reflexes and responses that affect our mind and body as we become prepared to avoid or deal with dangerous situations.
Anxiety protects us in 2 main ways:-
It helps to prepare our body for action, making us more alert and ready to fight or flee from any imminent threat to our survival. This is responsible for the direct physical sensations (such as rapid heartbeat, fast breathing, being jittery and on-edge, trembling etc.) that we feel when anxious. In real danger we can go from being totally relaxed to extremely anxious in an instant which is panic.
This aspect of anxiety makes us feel physically scared, particularly when our heart speeds up. Indeed, some research shows that heartbeat rate may be one of the main indicators of anxiousness. In one experiment – what distinguished those bomb disposal volunteers (all heroes) that had been decorated for gallantry from those that had not was the rate of their heartbeat. The ones that received medals maintained a lower cardiac rate when making stressful decisions.
Here, anxiety forms the basis of problems such as general nervousness, social phobias (in fact, almost all phobias) and panic disorder.
It causes us to plan ahead for any potential dangers and how to deal with them – an excellent survival strategy (it's better to deal with a danger or avoid it before we get into the situation) but an unfortunate effect of this is that we can get anxious / nervous just thinking about situations.
This aspect of anxiety leads to being mentally scared and apprehensive and involves vague thoughts that something bad may happen.
A main ingredient in many anxiety problems, this relates to symptoms such as excessive and obsessive thinking, planning and worrying. It underlies anxiety disorders such as obsessive compulsive disorder (OCD) and generalized anxiety disorder (GAD) and also plays a major role in severe depression.
The preparation to avoid danger completely or deal with it by fighting or fleeing is associated with a multitude of symptoms.
Some general situations which often cause anxiety include:
Anxiety typically involves an emotional component (e.g. fear, nervousness), a physiological component (e.g. fast breathing, trembling, dry mouth, heart racing, stomach churning) and a cognitive component (frightening or negative thoughts, e.g. I'm going to fail/make a fool of myself/loose control). These can then affect our behavior, for example by putting off or stopping work, avoiding people or situations, not sleeping, drinking too much or taking illicit substances.
How you can help yourselfFirst of all, you need to know that anxiety is entirely normal. Everyone feels anxious when they are in a stressful situation where they feel vulnerable, so being anxious does not mean that you are 'weak' or 'abnormal'.
In fact, a certain level of stress can be very helpful - it can motivate us, be exciting or invigorating, and enable us to reach higher and meet new challenges. After all, if we never tackled things that we found challenging, that we were uncertain that we could succeed at, we would stop learning or moving on in life.
However, it is also the case that too much stress can seriously interfere with living a normal life. Nonetheless, acute anxiety states are time-limited and will start to fade away in a relatively short period of time. Even when the anxiety is intense, you can still probably function better than you expect, and other people are often unaware of how you are feeling.
Here are some strategies you can try for yourself:
1. Review the stressful circumstances in your life. Think about all the things that are going on in your life which might be causing you stress. When possible, try to find practical solutions to reduce these sources of stress. This might include:
If you are uncertain about what is making you anxious, talk this through with a counselor to explore and understand the anxiety and how to deal with it.
2. A rational approach to challenging negative thoughts
When people are very anxious they tend to exaggerate how threatening a situation is, and to underplay how effectively they can cope with that situation. Our thoughts are distorted by our emotional state, and it can help to "stand back" and evaluate the situation more realistically when you feel calm. Below is a rational approach to put the fears into perspective, to challenge their validity, or to find an alternative view of your situation. Ask yourself questions such as these:
Are you judging yourself harshly?
Some people find it more effective to distract themselves from their frightening thoughts, perhaps by repeating a calming phrase to themselves such as "Stay calm and relaxed. I will feel better soon", or by doing mental arithmetic or saying the alphabet backwards. You can also try to distract yourself by focusing your attention on some external stimulus such as listening to a conversation, watching television, or becoming aware of what is going on around you. If you can stop attending to frightening thoughts, these will no longer be able to fuel your anxiety.
N.B. This is not the same as avoidance! It aims to help you stay in the stressful situation, not to opt out of it.
4. Face the situation
Confronting, rather than avoiding anxiety-provoking situations also helps. When anxiety occurs in certain situations it has become a learned response to those situations and it is a question of learning a new (relaxed) response. If you make yourself stay in the feared situation for long enough, the anxiety will reduce over time until it is completely extinguished. You could draw up a hierarchy of your feared situations, confronting the least threatening situation first and experience the diminution of your anxiety in that situation before progressing to a slightly more threatening situation in your hierarchy.
5. Learn to relaxThe physical symptoms of anxiety occur because adrenaline is released by the nervous system into the blood stream and affects organs such as the heart, stomach and muscles. Relaxation and breathing exercises can help you to control these symptoms. You can learn how your body feels when it is relaxed if you tense different parts of your body (e.g. arms, hands, legs, neck, shoulders, forehead) for a few seconds, and then allow them to relax. Try to keep your breathing slow and regular so that you do not hyperventilate, which makes the physical symptoms worse.
It may help you to join a relaxation class. Relaxation exercises need to be practiced initially when calm - you will become better able to relax in stressful situations with increasing practice.
Panic Attacks
A panic attack is a severe experience of anxiety. People may feel intense dread, experience various physical symptoms and have extreme thoughts of losing control, going mad, having a heart attack or dying. It is also possible to become afraid of panic attacks themselves because the experience can be so unpleasant. Paradoxically this tends to make a person even more prone to having an attack!
Although panic attacks can be very frightening, they are not actually harmful - people do not actually have heart attacks, develop psychiatric illnesses or die from them!
Here are some strategies to help in the event of a panic attack:
Anxiety can affect your health only when it becomes chronic and severe, so it is important that you seek help if you think that this is the case:
Anxiety protects us in 2 main ways:-
It helps to prepare our body for action, making us more alert and ready to fight or flee from any imminent threat to our survival. This is responsible for the direct physical sensations (such as rapid heartbeat, fast breathing, being jittery and on-edge, trembling etc.) that we feel when anxious. In real danger we can go from being totally relaxed to extremely anxious in an instant which is panic.
This aspect of anxiety makes us feel physically scared, particularly when our heart speeds up. Indeed, some research shows that heartbeat rate may be one of the main indicators of anxiousness. In one experiment – what distinguished those bomb disposal volunteers (all heroes) that had been decorated for gallantry from those that had not was the rate of their heartbeat. The ones that received medals maintained a lower cardiac rate when making stressful decisions.
Here, anxiety forms the basis of problems such as general nervousness, social phobias (in fact, almost all phobias) and panic disorder.
It causes us to plan ahead for any potential dangers and how to deal with them – an excellent survival strategy (it's better to deal with a danger or avoid it before we get into the situation) but an unfortunate effect of this is that we can get anxious / nervous just thinking about situations.
This aspect of anxiety leads to being mentally scared and apprehensive and involves vague thoughts that something bad may happen.
A main ingredient in many anxiety problems, this relates to symptoms such as excessive and obsessive thinking, planning and worrying. It underlies anxiety disorders such as obsessive compulsive disorder (OCD) and generalized anxiety disorder (GAD) and also plays a major role in severe depression.
The preparation to avoid danger completely or deal with it by fighting or fleeing is associated with a multitude of symptoms.
Some general situations which often cause anxiety include:
- leaving home and / or adapting to life at university
- moving to a new area or new job
- giving presentations, or performing in social situations
- coping with work and exams
- dealing with relationships or the lack of relationships
- sexuality issues
- preparing to leave university.
- apprehension about entering new or situations
- having to deal with people in authority
- worrying about whether you have chosen the right course or job
- panic about facing exams or making a presentation
- worrying about social acceptance and approval, or about failure, criticism or rejection from others
- fears about health.
Anxiety typically involves an emotional component (e.g. fear, nervousness), a physiological component (e.g. fast breathing, trembling, dry mouth, heart racing, stomach churning) and a cognitive component (frightening or negative thoughts, e.g. I'm going to fail/make a fool of myself/loose control). These can then affect our behavior, for example by putting off or stopping work, avoiding people or situations, not sleeping, drinking too much or taking illicit substances.
How you can help yourselfFirst of all, you need to know that anxiety is entirely normal. Everyone feels anxious when they are in a stressful situation where they feel vulnerable, so being anxious does not mean that you are 'weak' or 'abnormal'.
In fact, a certain level of stress can be very helpful - it can motivate us, be exciting or invigorating, and enable us to reach higher and meet new challenges. After all, if we never tackled things that we found challenging, that we were uncertain that we could succeed at, we would stop learning or moving on in life.
However, it is also the case that too much stress can seriously interfere with living a normal life. Nonetheless, acute anxiety states are time-limited and will start to fade away in a relatively short period of time. Even when the anxiety is intense, you can still probably function better than you expect, and other people are often unaware of how you are feeling.
Here are some strategies you can try for yourself:
1. Review the stressful circumstances in your life. Think about all the things that are going on in your life which might be causing you stress. When possible, try to find practical solutions to reduce these sources of stress. This might include:
- saying "no" to things you do not want to do
- giving up unnecessary, time-consuming activities and responsibilities
- confronting work problems by talking to your tutor, director of studies or supervisor/manager
- using an organised and realistic plan of action to tackle projects
- asking for information or feedback if helpful
- discussing a relationship problem.
If you are uncertain about what is making you anxious, talk this through with a counselor to explore and understand the anxiety and how to deal with it.
2. A rational approach to challenging negative thoughts
When people are very anxious they tend to exaggerate how threatening a situation is, and to underplay how effectively they can cope with that situation. Our thoughts are distorted by our emotional state, and it can help to "stand back" and evaluate the situation more realistically when you feel calm. Below is a rational approach to put the fears into perspective, to challenge their validity, or to find an alternative view of your situation. Ask yourself questions such as these:
Are you judging yourself harshly?
- Are you focusing on your failures and forgetting your successes? Have you managed to survive similar situations in the past (or even to succeed despite them!)? Are you judging your entire existence on the basis of this one event or one part of life, or are you expecting to be perfect?
- Are you seeing things in all or nothing terms, or assuming that to not succeed would be an absolute catastrophe?
- Are you assuming that you know what will happen in the future?
- What evidence have you got that your fears are valid?
- Are you exaggerating the chance of something going wrong or minimizing the possibility of your working it out fine?
- Are you spending time frightening yourself about situations that you aren't actually facing at present, and which may never happen?
- Are you assuming that everyone else is doing fine except you, when you don't actually know how others are feeling or managing?
- Are you blaming yourself for things that you cannot control, or are not your responsibility?
- Irrational: "I'll make a fool of myself in front of all these new people and they won't like me."
- Rational: "A lot of people will be feeling anxious like me. If I try to be friendly and pleasant, people have responded well to that in the past - I should be able to do it this time as well."
- Irrational: "I'm going to sound like an idiot at the presentation."
- Rational: "I have been doing my research and prepared well. My presentation looks good and I have managed to do it before.
Some people find it more effective to distract themselves from their frightening thoughts, perhaps by repeating a calming phrase to themselves such as "Stay calm and relaxed. I will feel better soon", or by doing mental arithmetic or saying the alphabet backwards. You can also try to distract yourself by focusing your attention on some external stimulus such as listening to a conversation, watching television, or becoming aware of what is going on around you. If you can stop attending to frightening thoughts, these will no longer be able to fuel your anxiety.
N.B. This is not the same as avoidance! It aims to help you stay in the stressful situation, not to opt out of it.
4. Face the situation
Confronting, rather than avoiding anxiety-provoking situations also helps. When anxiety occurs in certain situations it has become a learned response to those situations and it is a question of learning a new (relaxed) response. If you make yourself stay in the feared situation for long enough, the anxiety will reduce over time until it is completely extinguished. You could draw up a hierarchy of your feared situations, confronting the least threatening situation first and experience the diminution of your anxiety in that situation before progressing to a slightly more threatening situation in your hierarchy.
5. Learn to relaxThe physical symptoms of anxiety occur because adrenaline is released by the nervous system into the blood stream and affects organs such as the heart, stomach and muscles. Relaxation and breathing exercises can help you to control these symptoms. You can learn how your body feels when it is relaxed if you tense different parts of your body (e.g. arms, hands, legs, neck, shoulders, forehead) for a few seconds, and then allow them to relax. Try to keep your breathing slow and regular so that you do not hyperventilate, which makes the physical symptoms worse.
It may help you to join a relaxation class. Relaxation exercises need to be practiced initially when calm - you will become better able to relax in stressful situations with increasing practice.
Panic Attacks
A panic attack is a severe experience of anxiety. People may feel intense dread, experience various physical symptoms and have extreme thoughts of losing control, going mad, having a heart attack or dying. It is also possible to become afraid of panic attacks themselves because the experience can be so unpleasant. Paradoxically this tends to make a person even more prone to having an attack!
Although panic attacks can be very frightening, they are not actually harmful - people do not actually have heart attacks, develop psychiatric illnesses or die from them!
Here are some strategies to help in the event of a panic attack:
- Remind yourself that a panic attack will end!
- Remind yourself that panic attacks are not actually dangerous!
- Remind yourself of any previous occasions when you handled a similar situation well.
- Picture a person you trust or who cares about you and imagine the person is with you offering encouragement.
- Focus on the present moment and on the things around (outside of) you - observe their shape, colour, sounds...
- Stop what you are doing and slow yourself down for a moment! Breathe more slowly and gently (though not actually holding your breath). Then continue what you were doing slowly.
- Take a big sigh, stretch out, and then flop and relax.
- If you are able, take some gentle exercise, e.g. go for a stroll.
- Get angry! Don't let this anxiety (or situation) get the better of you!
Anxiety can affect your health only when it becomes chronic and severe, so it is important that you seek help if you think that this is the case:
- if the anxiety problems do not start to improve despite trying the ideas above
- if your fears are persistent and difficult to control
- if your anxiety is stopping you from living a normal life, or if you are avoiding important activities.
- Speak to a close friend, a family member or your G.P.
Ways to deal with worrying
Postpone worrying:
To do this properly, schedule a 30-minute worry break. As soon as you catch yourself worrying, tell yourself you’ll really be able to worry about the matter at that time. When that golden time rolls around, sit down with paper and pen and worry to your heart’s content. However, be sure to think your problems through completely, to the point where you figure out what you would do if catastrophe actually did strike.
Be realistic about the downside:
While you are sitting there with your paper and pen during your worry period, make yourself write out what could be the worst thing that could happen, regardless of what it is you are worrying about. Force yourself to be realistic about the possibility that that will occur.
Focus on your successes:
Compile a list of the many projects you’ve been involved with at work, and what the outcome was for each. Chances are you’ve had a lot more success than failure. The trouble is, we have a short memory when it comes to success and a long memory about our failures in life. Writing that list of successes can make a dent in your self-doubts.
Take a short relaxation break:
When worry strikes or when nearing the end of your worry break, spend a few minutes to let the stress dissolve. Sit quietly and focus on your breathing, sip herbal tea and visualize a restful scene, or give yourself a 10-second neck and shoulder massage.
Postpone worrying:
To do this properly, schedule a 30-minute worry break. As soon as you catch yourself worrying, tell yourself you’ll really be able to worry about the matter at that time. When that golden time rolls around, sit down with paper and pen and worry to your heart’s content. However, be sure to think your problems through completely, to the point where you figure out what you would do if catastrophe actually did strike.
Be realistic about the downside:
While you are sitting there with your paper and pen during your worry period, make yourself write out what could be the worst thing that could happen, regardless of what it is you are worrying about. Force yourself to be realistic about the possibility that that will occur.
Focus on your successes:
Compile a list of the many projects you’ve been involved with at work, and what the outcome was for each. Chances are you’ve had a lot more success than failure. The trouble is, we have a short memory when it comes to success and a long memory about our failures in life. Writing that list of successes can make a dent in your self-doubts.
Take a short relaxation break:
When worry strikes or when nearing the end of your worry break, spend a few minutes to let the stress dissolve. Sit quietly and focus on your breathing, sip herbal tea and visualize a restful scene, or give yourself a 10-second neck and shoulder massage.
Here is a useful video on youtube on how to deal with anxiety.
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