Living In Anxious Times

By David Edris - Sydney Psychotherapy

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Have You Suffered From A Panic Attack?

Everyone occasionally experiences some anxiety. It is a normal response to a stressful event or perceived threat and indeed anxiety isn’t always a bad thing. In fact, anxiety can help you stay alert and focused, spur you to action, and motivate you to solve problems. However, when anxiety is constant or overwhelming, when it interferes with your relationships and activities, it stops being functional and that’s when it has crossed the line. The purpose of this article is to give a handle on what suffering from anxiety is and means, and what steps you can take to help manage it.

So let us first discuss what exactly constitutes an anxiety attack (often referred to as a panic attack). They are episodes of intense panic or fear, which usually occur suddenly and without warning (notwithstanding there can be obvious triggers, such as giving a speech or getting stuck in an elevator).

These attacks usually peak within ten minutes, and they rarely last more than thirty minutes, but the intensity of feeling can be extremely severe; so much so that someone suffering an attack may feel that they are going to totally lose control of themselves and even die. Typically symptoms are as follows:

A feeling of overwhelming panic
A sense that you are losing control or going crazy
Chest pains
Heart palpitations
Hyperventilation, trouble breathing, or a choking sensation
A significant change in body temperature; either hot flushes or chills
Trembling or shaking
Nausea or stomach cramps
Feeling detached or unreal or confused

What Causes Anxiety?

There is not one single cause of anxiety, but many potential factors that can contribute to anxiety. More recent scientific research has even shown that some people are genetically predisposed towards suffering from anxiety. For example, some people, no matter their circumstance or situation, will tend towards preparing for doom. They are just born worriers and their brains are hard-wired to anticipate something dreadful (see Kagan and Fox’s longitudinal studies at Harvard and the University of Maryland).

But it’s not just hereditary. Research also suggests that people who experience a high level of anxiety may have an imbalance of chemicals in the brain that regulate feelings and physical reactions. These thoughts can often be traced to over reactivity in the amygdala, a small site in the middle of the brain that, among its many other functions, responds to novelty and threat. Other physiological differences associated with people prone to anxiety disorders are a tendency to more activity in the right hemisphere, the half of the brain associated with negative mood and anxiety, and higher levels of the stress hormones cortisol and nor epinephrine. As one might expect, medication that helps to correct these imbalances can relieve some symptoms of anxiety in some people.

Certain thinking styles can also make people more at risk of high anxiety than others. For instance, people who are perfectionist or expect to be in constant control of their emotions are more at risk of worrying when they feel stress; and this ties into that person’s life experience. For example, if someone has experienced difficult life challenges (such as bullying, conflict, or a family break up) the stress this puts on their coping resources can leave them vulnerable to anxiety in the future.

As is evident, there is no hard and fast rule as to why you might suffer from anxiety, but even a superficial understanding of the causes that could make an individual susceptible can help in the treatment of anxiety.

Tips On Managing Anxiety

Whatever the reason, perhaps the most important thing is knowing how to manage or cope with anxiety. Stage one is to look at your lifestyle and take some important initial steps. These include:

* Engaging in physical activity each day. This doesn’t have to be something big or expensive as long as it is real exercise and improves your fitness. Depending on your fitness level, a gentle walk may be a starting point, working towards something more physically challenging as your health improves.
* Reduce caffeine intake. Caffeine is a stimulant and one of its side-effects is to keep us feeling alert and awake. It also produces the same physiological arousal response that is triggered when we are subjected to stress. Too much coffee will keep us tense, and aroused, leaving us more vulnerable to anxiety.
* Similarly, alcohol, nicotine (cigarettes) and other drugs all have dramatic effects on the body at a physiological level; the results of which are unnatural and leaves us more vulnerable to anxiety and depression.
* As the saying goes “you are what you eat”; so adopt healthy eating habits. By starting the day right with breakfast, and continuing to eat healthy foods (small meals frequently) throughout the day, you are giving yourself the best chance be physically and mentally fit.
* The scientific evidence for the importance of sleep is overwhelming. A lack of sleep can exacerbate anxious thoughts and feelings, so try to get 7 to 9 hours of quality sleep a night.

Once these initial steps have been taken, the framework is in place for coping mechanisms to be utilized more effectively.

Coping Mechanism 1 – Identification of stress and trigger factors

The first step in managing anxiety is to identify the specific situations that are making you stressed or anxious and when you are having trouble coping. One way to do this is to keep a diary of symptoms and what is happening when anxiety occurs. It helps to identify a recurrence of worrying thoughts as this can lead to finding ways to solve the specific problem that is of concern. Once you have identified a specific situation or pattern that is causing the anxiety, use this process to work through the problem:

Write down the problem and be very specific in your description, including what is happening, where, how, with whom, why, and what you would like to change.
Come up with as many options as possible for solving the problem, and consider the likely chances that these will help you overcome your problem.
Select your preferred option.
Develop a plan for how to try out the option selected and then carry it out.
If this option does not solve the problem remember that there are other options to try.
Go back to the list and try your next preferred option.

Coping Mechanism 2 – Breathing exercises

When people feel anxious they often breathe more rapidly. This in turn leads to feelings such as light-headedness, confusion, hyperventilation and increased anxiety. Learning a breathing technique to slow down breathing can often relieve symptoms and help a person to think more clearly. The most important thing is to use what is often called “diaphragmatic breathing”; using the expansion of your abdomen to breathe into your tummy. The following simple breathing technique can slow down breathing and reduce symptoms of anxiety. You should begin by timing your breathing and then complete the following steps.

Breathe in through your nose to the count of three (3 seconds) and say to yourself: “IN, TWO, THREE”.
Breathe out (through your nose or mouth), again counting to three, and say to yourself: “RELAX, TWO, THREE”.
If you can breathe continually through the count of three, slow it down to a count of four seconds, remembering that the in and out breath should be the same length. Once you can continue through a four count, slow it down to a five count, and so on.
You should practice diaphragmatic breathing each day for 10 minutes. During the exercise focus all your attention on your breathing; noticing how the air travels through your nostrils and fills your stomach. Do not try to inhale large amounts of air. The purpose is to have a slow, steady inhale and exhalation, with your attention on the breathing. If you have difficulties using your diaphragm to breathe it may help to lie on the floor (tummy down) and feel the physical sensation of your stomach expanding as you breathe in and contracting as you breathe out. Once you have the “feel”, copy the exercise standing up. Done properly, diaphragmatic breathing will help you feel calmer and more in control and can prevent an anxiety attack from manifesting. It can also be used in conjunction with the other coping mechanisms, but it takes practice to become proficient so keep practicing for a minimum of 10 minutes a day (and think of it as a necessary investment in your well being).

Coping Mechanism 3 – Relaxation techniques

Knowing how to release muscle tension is an important anxiety treatment. Relaxing can bring about a general feeling of calm, both physically and mentally so learning a relaxation technique and practicing it regularly can help a person to maintain a manageable level of anxiety. A popular technique is “progressive relaxation”; where you alternately tense and relax your muscles in a systematic way starting at your feet, moving through your legs, abdomen, chest, arms and face. As you tense and relax your muscles in a sequential pattern, keep your eyes closed and tense for 10 seconds and then release for 20 seconds before continuing with the next muscle group. Whilst doing so, focus on the difference between the feelings of the tension and relaxation. This in turn teaches the mind and body to understand the difference in sensation and encourages muscle relaxation.

Coping Mechanism 4 – Thought management

Thought management exercises are useful when a person is troubled by ongoing or recurring distressing thoughts. There is a range of thought management techniques. For instance, gentle distraction using pleasant thoughts can help take attention away from unpleasant thoughts. Alternatively, one can learn ‘mindfulness techniques’ to redirect attention from negative thinking. A simple technique is ‘thought replacement’ or using coping statements. Develop a set of statements that will counteract worrying thoughts (e.g., “This is difficult but I have been through it before and have got through it okay”, “Hang in there, this will not last much longer”). Substitute one of the reassuring or coping statements for the troubling thought.

An excellent list of coping statements and general resource on anxiety can be found at:

http://www.sydney-psychotherapy.com.au/anxiety-therapy-treatments-sydney/

There you can also find an excellent worksheet called Misbelief Vs Truth, which will help you put down distorted thoughts and replace them with calming statements.

Managing Anxiety Is A Process

For most people, there is no golden ticket. You can’t just click your fingers and find yourself free of anxieties. For whatever reason, if you suffer from anxiety, it is likely to take some effort and continual work to overcome those anxious tendencies. However, with commitment to the process and varying degrees of hard work you can condition yourself to respond to stimuli in a calmer fashion. Through a dedicated approach to your practicing the above mechanisms, over time you will find that it is entirely possible to have a “natural” response to things that used to make you anxious.

Professional Treatment

If you require further assistance, many types of professional therapists and psychologists can help in the effective treatment of anxiety. Speak to your general practitioner or local counselling/therapy/psychology board who will be able to provide you with more information on specific treatment options that might be suitable for you.