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Breathing | Relaxing | Controlling Anxiety | Negative Thoughts | Our Rights | Medications


LEARNING TO CONTROL SYMPTOMS

Can you control your symptoms already?

Many people discover their own ways of controlling anxiety. Some try to relax, or breathe slowly, some try to take their minds off the problem, and some find that it helps to be with another person. Do you already know how to control your anxiety? Before reading further, think about the answers to the following questions. Think about each one carefully and then write down your answer.

Is there anything that you already do when you feel anxious, tense or worried that makes you feel better? If so, what is it

Do any of the things that you do make you feel worse? If so, what

Is there anything that you feel might help if only you could do it? If so, what?

HOW SHOULD ANXIETY BE CONTROLLED?

Four methods that have generally been found helpful are described on the following pages.

These methods are:-

1. Learning to relax

2. Learning how to take your mind off the problem (distraction).

3. Learning how to control upsetting thoughts.

4. Learning how to manage feelings of panic, or of being out of control.

You may have tried some of these things already. If you have done so and found they did not work, do not worry. This may be because you gave up too soon, or did not realise how much practice was necessary. It is hard to persist if you are not sure that you are doing the right sort of thing. These methods have to be carefully learned and practised regularly before they can be used effectively.

Now read about all four of the methods and then think about which would be the best one for you to learn first.

RELAXATION

Why is relaxation helpful?

Because muscular tension causes uncomfortable bodily feelings, such as headache and backache.

Because people who are tense often feel tired.

Because relaxing slows down the systems in the body that speed up when you get anxious.

Why do we talk about ‘learning’ to relax?

Because it does not come naturally. Not many people can deliberately relax even if they want to. It is especially difficult if you are feeling anxious.

Before reading on, answer the following 3 questions:

1. Are you often aware of feeling tense physically?

2. If so, which part of your body feels tense?

3. When does this happen?

HOW WILL YOU LEARN TO RELAX?

1. First, you should learn how to relax your whole body completely. You may be given tape recorded instructions to listen to at home. If so, you should practice relaxation each day using this tape.

2. Then you should learn how to shorten the exercises so as to be able to relax more quickly

3. Finally, you should learn how to use the exercises when you are feeling anxious or tense.

These exercises will enable you to control your level of tension. When practising, you should have two aims

i. To learn what it feels like to be totally relaxed

ii.To discover where the centres of tension in your body are. Once you can control these, you will be able to stop yourself becoming tense

Regular practice is essential. It should be regular and unhurried. You should find a place to do it where you can be warm and comfortable and will not be disturbed. To begin with, remember that you are learning a new skill and concentrate on learning how to do it in quiet surroundings. There will be plenty of time later to practise using the new skill when you are actively doing things.

Now decide where you could practise relaxation exercises.

At what time of day could you practise?

Make this your regular time. Practise every day.

LEARNING TO RELAX MENTALLY AS WELL AS PHSYCIALLY

Some people find they can relax physically but that they keep thinking about worrying or upsetting things. Their mind does not feel relaxed at the same time if this happens, you can improve the relaxation by using relaxing thoughts or images.

1. Write down a list of events or situations that you find completely relaxing. Try to find 3 or 4 different things, for example, sitting by a warm fire on a winter evening with a cup of tea, or lying down by a beautiful lake in the sunshine, or listening to some music that you know well.

2. As you relax after doing your exercises, imagine that you are in that relaxing situation. Make it as realistic as you can.

Do not worry if you cannot concentrate for very long on one image. If you have several, you can try them one after another. With practice, you will become able to stop the worrying thoughts for longer periods.

HOW DO YOU USE RELAXATION WHEN YOU ARE ANXIOUS?

Once you have learned how to relax in quiet surroundings, you should start to use relaxation when you are anxious.

By the time you are ready to do this, you should know which part of your body tends to get most tense. You can improve you relaxation by working on keeping this part relaxed. Some of the suggestions that others have found useful are:

1. Dropping your shoulders

2. Relaxing one part of the body, e.g. a hand or a foot

3. Breathing slowly and evenly

4. Saying something to yourself like ‘keep calm’ or ‘let go’

You should check how tense you are regularly during the day, and follow this by trying to relax.

Remember that it takes time to learn how to relax quickly, so give yourself a chance and do not expect to succeed too soon.

SOME FURTHER POINTS ABOUT RELAXATION

1. Controlling your breathing

When they are anxious, some people breathe more rapidly. This ‘anxious’ breathing can produce symptoms such as trembling, heart thumping, tingling in the hands and feet, and dizziness. The symptoms can be quickly controlled by correcting your breathing.

Take a deep breath in; hold it while you count slowly up to 3; and then let it all go. Repeat this if necessary and try to replace the fast, shallow breathing with slow relaxed breathing. About 8-12 complete breaths in a minute would be quite relaxed.
Do not take lots of deep breaths in and out in quick succession as this can make you feel dizzy and uncomfortable.

2. Posture

Whether you are standing or sitting, try to be in a relaxed posture. Don’t sit on the edge of a chair, don’t hunch up your shoulders, don’t clench your fists. Being tense can be very tiring. Do not waste energy by adopting an uncomfortable position, but allow your body to rest comfortably even when doing things. For example, try to relax when you are eating meals or waiting in a queue.

3. Haste

Do you feel you have to rush to get through all the things you have to do in a day? This can be a source of strain or tension.

Think about some of the following questions:

Do you really do things better or more efficiently if you are in a rush?

Could you organise things differently so as to be less rushed?

Could some things you plan to do be left to another day?

What would happen if you failed to do something you had planned to do? Would it really matter?

Do you give yourself enough time in which to relax and recover after dashing about?

DISTRACTION

Why is distraction helpful?

When you are worried or feel tense, it is often difficult not to think about it. But these thoughts end up making you feel worse. They keep the vicious circle of anxiety going.

If you do not let yourself pay attention to your symptoms, then they will die away of their own accord.

As you know, it is very difficult just to turn your attention away from unpleasant feelings. There are two things you have to do:

1. Decide not to think about them, and

2. Fill your mind with something else - distract yourself.

Now answer these questions:

Do you find that you feel better if you get involved in doing something?

If so, what do you get involved in?

HOW CAN YOU DISTRACT YOURSELF?

There are many ways in which you can distract yourself.

Some of the activities others have found useful include:

1. Concentrating on what is happening around you.

For example, you could listen to someone else’s conversation, or count how many different red things you can see. Choose something that engages your attention. When distracting yourself, it helps to give yourself a specific task, like guessing what job people do, or deciding what you would buy in each shop window.

2. Mental activity.

This includes activities such as doing mental arithmetic, calculating prices, reciting a poem to yourself, or even doing a crossword puzzle.

3. Physical activity.

Keeping yourself occupied can also distract you from your thoughts. Possible activities include doing the mending, washing the car, or taking the dog for a walk.

LEARNING HOW TO CONTROL UPSETTING THOUGHTS

Why learn to control upsetting thoughts?

You may have noticed that thoughts can make you feel anxious, or keep the anxiety going, even thought they are not put into words. They may be more like half-formed ideas, or pictures in your mind. They play a major part in the vicious circles described later.

An example may help to make this clearer. Imagine you are running upstairs one day when you feel a sudden sharp pain in the chest. It gives you a fright, and the thought goes through your head: “Maybe there’s something wrong with my heart.” The thought itself makes you more afraid, your heart beats faster, and the pain seems to take a very long time to die away. Later on that day the same thought comes back to you. Once again, your heart beat increases and you feel afraid. The symptoms produced the thought, which made you anxious and added to the symptoms.

Now think about the answers to these questions:

What goes through your mind when you feel tense or anxious?

Do you have thoughts that make you feel worse?

If so, what are they?

GET TO KNOW YOUR OWN UPSETTING THOUGHTS

Find our what you are thinking.

This is easier said than done because the sorts of thoughts that make anxiety worse are difficult to identify. They come and go very quickly, and may also have become ‘automatic’. This means that they are like bad habits. You may not be fully aware that they are there because they are so familiar.

Try to write down your own ‘anxious’ thoughts. If you find that difficult, try to remember a situation that actually upset you. See if you can put into words the thoughts that went through your mind as anxiety built up. Pay close attention to your thoughts next time you feel anxious or tense.

Remember that no thoughts are too small or too silly to write down. Even thinking ‘Here I go again’, or ‘My back aches’, can keep you feeling tense. Chasing the thoughts away can break the vicious circle and make you feel better. You cannot learn to do that until you know what you are thinking.

FINDING AN ANSWER TO YOUR UPSETTING THOUGHTS

Once you know what you are thinking, then you can learn how to examine and answer the thoughts in a way that makes you feel better.

Some of the thoughts you identify may at once seem unrealistic or exaggerated, like ‘everything is bound to go wrong’. Answering this thought would involve thinking about all the things that are likely to go right.

Other thoughts seem to focus entirely on the bad side of things, like ‘I had a dreadful day yesterday, everything was terrible’. The ‘positive’ things are often forgotten when you are not feeling your best. But remember, if ‘yesterday’ was the bad day, then maybe ‘today’ or ‘the day before yesterday’ will be better days. Think of them instead.

The aim is to learn to ‘catch’ upsetting or frightening thoughts and to find a better way of thinking about the same things. This may seem difficult at first, but it will become easier with practice. Because it is rather complicated, this is one of the things that you may want to discuss in further detail later.

ORGANISING SELF-HELP DURING TRAVEL

Organise a Comfort Bag for yourself:-

What do you do when you're away from home or secure surroundings, and anxiety strikes? Reach into your comfort bag for security, distraction or relaxation.

How to go about it:-

1. Choose a bag.

Decide what kind of a bag is appropriate for your needs. If you drive a lot, you can take more in the car. If you carry a purse or handbag, maybe a large one is in order. A backpack, satchel or holdall is an option for anyone, or perhaps even a briefcase?

2. Brainstorm.

Now...time to collect your thoughts. Sit down with a pen and paper and write down anything that comes to mind that has helped relieve your anxiety in the past. Add to the list anything that you'd like to try.

3. Pick the portable items from your list.

After your list is complete, decide what is portable, and put together your comfort bag.
Here are a number of suggestions to help you complete your list.

For Relaxation

Index cards (memory joggers) with relaxation and breathing exercises
Lavender oil and Bach Rescue Remedy
Hand cream (for hand massage)
Music & portable player
Relaxation tapes
Herbal tea

For Comfort

Photos
Cards/letters from loved ones
Teddy bear
Religious or spiritual items
Index cards with poems, quotes, and calming reminders

For Stimulation

Rubber bands (snap on wrist to help you focus thoughts)
Mints or sweets
Cold water
Mentholated cream (Vicks?) (to smell)
Upbeat music

For Distraction

Puzzle books
Magazines
Portable computer games
Journals/Magazines
Small children's toys
Colouring books
Books on tape or mp3 etc.
Pens, pencils, coloured pencils, crayons

For Emergencies

Mobile phone
Extra clothes (including something warm)
Blanket
Extra medication
Small phonebook with all your important numbers
Change for phone
Money
Toilet paper, wet-ones and kleenex
Maps

Tips:-

Have a list of people handy, that you can telephone if you're stuck somewhere. These would be people who could either come and get you, or talk to you until you feel calm again (make sure they've agreed ahead of time).
Forgetfulness is a common symptom during anxiety and panic. When you put together lists, like phone numbers, be sure to include even the most obvious (such as your mother) because you may forget the most obvious when you're anxious.

Remember that anxiety can make easy tasks more difficult, so be sure to bring distractions for an anxious mind (i.e. perhaps a children's puzzle book rather than an adult's). Don't be embarrassed about bringing what soothes you. If bringing your childhood teddy bear will help you recover quicker, then it's worth it!

SUMMARY OF ANXIETY MANAGEMENT SO FAR:-

1. Learning how to relax will help you feel less anxious, and help you to do things more easily.

2. Thinking about your symptoms makes them worse, so distracting yourself will make you feel better

3. If you can control upsetting thoughts, you will be more likely to control the vicious circle of anxiety.

WHEN TO USE ANXIETY MANAGEMENT

It is always easier to control anxiety in its earlier stages. This is why you must learn to recognise the beginnings of tension, and the things that go through your mind when you start to worry. These are the ‘early warning signals’ that tell you to take action.

Taking action early interrupts the vicious circle before it has a chance to get going.

If a technique does not work for you at first, it may be because you were already too panicky to use it. Do not be discouraged, try it again when you are not feeling quite so bad. The idea is to start at a point where you succeed, and then grow better at it, by building up your confidence and retaining your control.

PANIC MANAGEMENT

What should you do if you miss the early warning signals and anxiety builds up?

When you become very anxious and panicky, it is hard to think clearly. It is even harder to act sensibly. For this reason, you should learn beforehand what to do if you have a really bad panic.

1. Remember that the feelings of panic are normal bodily sensations. They are not harmful. Also, the panic reaction was triggered by a situation that is not actually dangerous.

2. Accept what is happening to you. Do not run away. If you wait, the fear will pass.

3. This is an opportunity to practise controlling your anxiety. Start by taking a deep breath and trying to slow down your breathing.

4. Try to think of the situation in a more positive way. This will stop you adding to the panic by thinking frightening thoughts.

5. When you begin to feel better, plan what to do to make the situation easier. Whatever you decide to do, carry it out in a relaxed way. Do not hurry.

GOOD LUCK

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