Advice: Anxiety

I have been wanting to write a post about anxiety for a while, to offer help for those suffering anxiety or feeling anxious about something, advice for their friends and family, and to refer to myself during any times of anxiety in the future (when I tend to forget things that help!).  I think it would be helpful to have everything I know about anxiety from reading about it, counselling and just personal experience, all in one place.  I think there is such a stigma around anxiety.  I know I feel really embarrassed and ashamed to suffer anxiety, and I am always conscious of talking to people about it in case they judge me, think I’m mental or get fed up with me 'going on' about it.  Sometimes I also worry that talking about it and engaging with the feelings will make it worse.  

So first off, if you are suffering from anxiety, please don't feel alone, or weird, or like a failure.  I have felt all of these things, but they're not true.  Unfortunately that's the anxiety making you anxious about the anxiety! Buggering anxiety. It's a bastard like that. Most people experience some type of anxiety in their lives. And those lucky few that don't will have other issues! If you're feeling anxious right now, know that many, many others are feeling just the same as you, and more importantly many, many others felt the same as you an hour ago but are now starting to feel better, and many, many others felt the same as you do now yesterday, or last week, or last month, but now life is more balanced and they feel ok. It DOES get better. Always. Although it doesn't feel like it, it really will.

Firstly I'll talk about the physical symptoms of anxiety, then the thoughts, and at the end will be advice for friends and family (although the whole post will be dotted with tips and reassurance for you).  

Anxiety is a normal physical response to a perceived threat.  So your brain thinks a thought that is stressful or scary, and your body reacts logically by releasing hormones and chemicals to make you able to fight or run away.  This physical reaction can make you feel really anxious because it doesn’t feel very nice! Which in turn makes your body produce more stress chemicals and it goes around in a cycle.  The good news then is that you can break the cycle and any one of three points! Either after your brain has the thought (by challenging the thought), after your body has kicked in with its response (by helping your body physically relax), or after your reaction to the physical symptoms (by accepting and not getting more stressed and worried about what is happening.)

The physical symptoms I get are that my stomach tightens, I feel sick, I lose my appetite, everything tastes horrible, I get a dry mouth, I get all sweaty, feel like I can't breathe very well with a tight chest, I get tingly fingers and toes, I can't sleep and if it's a full on panic attack as well as anxiety I get a ‘rushing up’ feeling through my body, I shake, get ringing ears, I feel dizzy, my heart races and I instantly get the shits. Good times! There are other symptoms if this doesn't cover yours, they are listed here and even better they are explained, so you can see exactly what is physically happening, why it’s happening, and that it's not something terrible.  It's common to really worry when you feel these symptoms that something is really wrong, that you're ill, having a heart attack or are going to die.  You’re totally not.  It's fine if you're worried, of course you are, it's shit to feel like that! But it's really not anything serious, whilst it is awful, it's just anxiety, and it will pass. 

Common thoughts I get are "I'm out of control", "I'm going mad", "I'm a failure", "I don't want this to happen again and "I'm never going to get better".  

One thing that can really help with the physical symptoms is breathing deeply and evenly from your stomach, which is called diaphragmatic breathing.  Put your hands on your tummy as you slowly, evenly, breathe in and out, and feel your hands rise and fall.  This helps your body calm itself down, realise there’s no threat and get all its systems back in order.  If you’re really freaking out, breathe into a paper bag (or into your cupped hands).  Count to 7 as you breathe in and 11 as you breathe out.

The next thing I do is see if I can have a jolly good cry! I find that bursting into tears (complete with massive, snotty, wracking sobs, red nose, etc. I am not a pretty crier!) can help get some of the emotions out.  You could also try screaming, punching something, running on the spot, dancing to some heavy music, throwing the anxiety away, anything to feel like you’re getting it out.

The next, and very important thing, is to try to just ‘go with it’. Fighting the anxiety or panic just feeds into it, making it worse.  Know that anxiety is just a feeling, like happiness, sadness, anger, joy etc.  When I get anxious I fear they it’s this awful ‘illness’ that I am ‘in’ and can’t get out of.  But this is not the case, anxiety is just an emotion.  Accept the feelings, feel them, don’t push them down. In my experience feelings just want to be felt and ignoring them makes them worse. They’re uncomfortable and horrible but they won’t kill you. Just go with it. I find that actually engaging with them in some form, whether by writing them down in a diary, or my favourite which is painting or drawing the emotion, purges them in some way. 

When I feel anxious I judge myself for having those feelings, and criticise myself, thinking I’m obviously failing or not doing very well if it’s happening again.  This is unhelpful and untrue.   Life isn’t one long up-curve where every day gets better and better, some days suck! For everyone, not just for people who feel more anxiety than others.  We all have bad days.  Don’t pressure yourself not to feel how you feel, as putting that pressure on yourself adds to the stress, and it’s ok to feel shit sometimes.  It’s awful to feel that way but it will go by itself, whatever you do. It will pass.  This is illustrated in a couple of children’s books which I have found really helpful: The Red Tree by Shaun Tan and Sometimes by Emma Dodd, which deal with emotions and that sometimes we do feel rubbish, but that it’s ok and normal.

If you can do anything at all to relax, do it! Relaxing your body loosens its grip on the stress, and the anxiety will in turn reduce, but don’t stress about trying to relax (or obviously that won’t work)! When I’m super anxious I make a hot cup of herbal tea and a hot water bottle to relax my tummy, lie on the sofa with QVC on in the background and do some internet shopping/fantasy shopping, I have also learnt some acupressure points to press or wear those travel sickness wristbands on (there’s a great app that will tell you where and how to press the points for anxiety, I had it on my iPhone but haven’t looked on Android yet)…whatever works for you! If you can’t relax ah well! That’s ok too. Try again tomorrow.

Distraction is also key.  Watching rubbish (AKA really good!) TV, going on the internet, drawing, cross stitch…anything that uses some of your brain but not in a stressful way.  Going for a walk is brilliant, and when you’re out become aware of birds singing, flowers, leaves on trees, anything positive, and try to let it ground you.  Walk for at least 15 minutes to get the endorphins flowing. 

When I’m feeling anxious I transfer some of those anxious feelings onto food and eating, so again distraction is useful.  I cook whilst Eric is there to distract me, and eat in front of the TV so I’m not thinking about it too much.  I get worried about what I’m eating and how regularly, and as I lose my appetite, get tummy ache and feel sick it’s hard to eat! I make sure I eat at normal times, but let myself eat a third less than usual if I really am struggling, which takes some of the stress out of it, and if I don’t fancy anything I eat fruit which I can always manage.  Just eat foods you like, at fairly regular intervals, and remember that in a few days it will be getting back to normal so don’t let it add to your worry.

Also when I’m anxious I start to stress that I won’t be able to sleep because of the anxiety, and thus I can’t sleep because of the anxiety! So I do things to distract myself at bedtime…going on the internet, knitting, reading etc. until I’m so sleepy I just fall asleep.  I also do a meditation in bed to help me feel ready for sleep, either listening to one on my iPod (I use the Rainbow Relaxation I used to listen to when I was pregnant from Marie Mongan’s ‘Hypnobirthing’!) or do a full body relaxation where you tense each muscle in your body then relax them one at a time, starting at the top of your head and working down, really being mindful and conscious of each part of your body and the feeling of it relaxing.  And sleeping with the window open a crack helps for some reason! In a few days or a week your sleep will regulate again so don’t worry if it takes longer to get to sleep or if you wake up in the night just now.  If you wake up, get up and do something distracting until you feel tired again rather than lying in bed stressing about not being asleep! If you try that and it doesn’t work then even just lying in bed with your eyes shut, resting, is good for your body.   

When I’m anxious, general life can feel very overwhelming, and at times in my life I’ve avoided going out or doing things I thought would make it worse.  Instead of avoiding everything, give yourself a break and don’t put too much pressure on yourself, but do things you would normally do, like going out to see your friends for lunch.  This will help ‘turn up’ normal life and ‘turn down’ anxiety.  Give yourself small challenges but take it easy on yourself too.

One thing I’m finding helpful with my anxiety is challenging the thoughts behind it.  I have been having CBT counselling for 4 and a half months now and it’s helping me unravel and address things.  I write a thought log every week, especially when I’m anxious, which involves separating out the trigger, the thought, the feeling, then seeing if I can challenge it.  Is the thought realistic? Am I catastrophising (making it into the worst thing ever)? Try doing this if you’re feeling anxious and see if you can identify any negative thoughts that you can challenge and make sense of.

Finally it can be helpful to make a list of positive things, to train your mind to focus on the positive rather than the negative.  Being a ‘glass half full’ person can be learned! When I’m feeling very low or anxious, if I can make a list of things that went well, e. g. anything I did well that day, however tiny, things that were happy or beautiful, things to be proud of or that I did that make me a great Mum, then the day doesn’t seem like a dead loss.  Over time this make you feel more cheerful and ‘in the moment’.  

Go easy on yourself, stay positive if you can, and remember you’re not alone.  You can and will feel better, and getting through this hard time will make you so much stronger.

I will finish up with some of my favourite quotes that have helped me alot:
"God never puts more on you than you can bear"
"It always seems impossible till it's done"
"You have to wade through the shit to get to the gold"
"A smooth sea never made a skilful sailor"
"When you're going through hell, keep going"
"Good things come to those who wait  Good things come to those who work their asses off and never give up"
"This too shall pass"
""Lord, you said that once I decided to follow you, you'd walk with me all the way.
I don't understand why, when I needed you most, you would leave me." The Lord replied, "My precious child.  I love you and I would never leave you.  During your times of trial and sufferingwhen you saw only one set of footprints...That was when I carried you.""

(courtesy of friends, things I have read, Charlotte Brydon-Smith and Mo Cahill)

Friends, family and loved ones:

1.     Well, firstly, read this post so you can understand and empathise with how your loved one might be feeling.
2.     If your loved one says they’re feeling anxious, try to avoid saying “why?” as this can sound a bit critical or add to their anxiety if they are unsure of the reason they’re feeling anxious.  Instead try asking “is there any reason you feel anxious?” and if they say no then you can reply “well that’s ok, everyone feels anxious sometimes, it will be ok”.
3.     If your loved one desperately begs you to tell them it’ll be ok, tell them that! My partner has said before “well I can’t tell you it’ll be ok as I don’t know anything about it so I don’t know if it will be ok”.  It really, really will be ok! They will be fine, anxiety is just a feeling that will pass.
4.     Don’t dismiss their feelings though.  Anxiety is horrible! Talk to them about their feelings if they want to, and be sympathetic and positive.
5.     Don’t say “pull yourself together” or “nothing’s wrong, you’ve got nothing to worry about”. 
6.     Remind them of their good points or things they have done well.
7.     Being supportive can be a question of finding the right balance. You need to accept the person as they are, and not push them into situations that are beyond them but at the same time try to help them to overcome small challenges. It will help them build up their self-confidence and feel in control.
8.     Reassure them that it’s ok and normal to feel bad sometimes and that it’s ok to cry or be down or feel angry or frustrated.  Encourage an outlet for these feelings.  Letting out their feelings can really help.
9.     Help them to have fun.  Do things that they enjoy that aren’t too challenging for them.  Laughter is the best medicine!
10.  Physical reassurance, like a hug, can be a great way of saying you’re there for them, and can really help.  

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