Understanding and coping with Anxiety
By Becci Grant, Wed 30th Oct 2019
Understanding and coping with anxiety
Anxiety is your body’s natural response to stress. It’s a feeling of fear or apprehension about what’s to come. The first day of school, going to a job interview, or giving a speech may cause most people to feel fearful and nervous.
But if your feelings of anxiety are extreme, last for longer than six months, and are interfering with your life, you may have an anxiety disorder.
It’s normal to feel anxious about moving to a new place, starting a new job, or taking a test. This type of anxiety is unpleasant, but it may motivate you to work harder and to do a better job. Ordinary anxiety is a feeling that comes and goes, but does not interfere with your everyday life.
In the case of an anxiety disorder, the feeling of fear may be with you all the time. It is intense and sometimes debilitating.
This type of anxiety may cause you to stop doing things you enjoy. In extreme cases, it may prevent you from entering an elevator, crossing the street, or even leaving your home. If left untreated, the anxiety will keep getting worse.
Anxiety disorders are the most common form of emotional disorder and can affect anyone at any age.
Anxiety is a key part of several different disorders. These include:
- Panic Disorder: Experiencing recurring panic attacks at unexpected times. A person with panic disorder may live in fear of the next panic attack.
- Phobia: Excessive fear of a specific object, situation, or activity
- Social Anxiety Disorder: Extreme fear of being judged by others in social situations
- Obsessive compulsive Disorder: recurring irrational thoughts that lead you to perform specific, repeated behaviours
- Separation Anxiety disorder: Fear of being away from home or loved ones
- Illness anxiety disorder: anxiety about your health (formerly called hypochondria)
- Post traumatic Stress Disorder: (PTSD): anxiety following a traumatic event
Anxiety feels different depending on the person experiencing it. Feelings can range from butterflies in your stomach to a racing heart. You might feel out of control, like there’s a disconnect between your mind and body.
Other ways people experience anxiety include nightmares, panic attacks, and painful thoughts or memories that you can’t control. You may have a general feeling of fear and worry, or you may fear a specific place or event.
Symptoms of general anxiety include:
- increased heart rate
- rapid breathing
- trouble concentrating
- difficulty falling asleep
Your anxiety symptoms might be totally different from someone else’s. That’s why it’s important to know all the ways anxiety can present itself.
An anxiety attack is a feeling of overwhelming apprehension, worry, distress, or fear. For many people, an anxiety attack builds slowly. It may worsen as a stressful event approaches.
Anxiety attacks can vary greatly, and symptoms may differ among individuals. That’s because the many symptoms of anxiety don’t happen to everyone, and they can change over time.
Common symptoms of an anxiety attack include:
- feeling faint or dizzy
- shortness of breath
- dry mouth
- chills or hot flashes
- apprehension and worry
- numbness or tingling
A panic attack and an anxiety attack share some common symptoms, but they’re not the same.
The Anxiety Trick
The Anxiety Trick is behind most of the trouble people have with chronic anxiety. Have you struggled to overcome an anxiety disorder, only to get disappointing results, or even feel worse over time? Then you’re being fooled by the Anxiety Trick.
This is a terribly common occurrence, and people mistakenly blame themselves for it. Here’s a more accurate, and helpful, way to understand this common and frustrating problem.
What is an anxiety disorder? It’s you getting tricked into feeling a powerful force of fear in the absence of any danger.
It’s because there’s no danger that people seek help for these fears. People recognise that they’re getting afraid when they’re not in danger. If they were actually in danger, they would just protect themselves as best they could, .
With an anxiety disorder, people get afraid when they’re not in danger. Their struggle to protect themselves from fear leads them down a path of increasing trouble. That’s the anxiety trick.
How does this happen, that you feel fear in the absence of danger? This is exactly the Anxiety Trick at work.
How You Get Tricked
* If you have a panic disorder or agoraphobia you keep getting tricked into believing that you’re about to die, go crazy, or lose control of yourself.
* If you have social phobia you keep getting tricked into believing that you’re about to look so unreasonably nervous in front of people that you will be completely humiliated and be cast aside by your community.
* If you have a specific phobia you keep getting tricked into believing that you’re likely to be overcome by some external object (like an elevator) or animal, or by your fear of it.
* If you have OCD you keep getting tricked into believing that you’ve set in motion a terrible calamity.
* If you have generalised anxiety disorder you keep getting tricked into believing that you’re about to be driven mad by constant worrying.
In each case, the episode of fear passes without the expected catastrophe. You’re none the worse for wear, except that you’re more worried about the next episode. The details seem different, but it’s the same anxiety trick.
What is the Anxiety Trick?
The Anxiety Trick is this: You experience Discomfort, and get fooled into treating it like Danger.
What do we do when we’re in danger? We only have three things: Fight, Flight, and Freeze. If it looks weaker than me, I’ll fight it. If it looks stronger than me, but slower, I’ll run away. And if it looks stronger and faster than me, I’ll freeze and hope it doesn’t see so good. That’s all we have for danger.
When people experience the fear of a panic attack, or a phobic encounter, or an obsessive thought, they instinctively treat it as a danger. They try to protect themselves, with some variation of Fight, Flight, or Freeze.
How People Get Tricked
People’s natural instincts to protect themselves are what lead them to get tricked. See if you recognise your responses in these examples below.
A person with Panic Disorder gets tricked into holding her breath and fleeing the store, rather than shifting to belly breathing and staying there until the feelings pass.
A person with generalised anxiety disorder gets tricked into trying to stop the unwanted “what if?” thoughts, rather than accepting them and taking care of present business as thoughts come and go.
A person with Social Phobia gets tricked into avoiding the party, or hiding in the corner if he attends, rather than say hello to a stranger and see what happens.
A person with OCD gets tricked into repeatedly washing his hands, or returning home to check the stove, rather than accepting the intrusive thoughts of contamination and fire and returning his energies to the present activities at hand.
A person with a dog phobia gets tricked into avoiding the feelings by avoiding all dogs, rather than spending time with a dog until the feelings pass.
What Maintains the Anxiety Trick?
You might wonder, why don’t people come to see this pattern, of repeated episodes of fear which don’t lead to the feared outcome, and gradually lose their fear?
The answer is this. They took these protective steps, and there was no catastrophe. They tend to believe that these steps “saved” them from a catastrophe. This thought makes them worry more about “the next time”. It convinces them that they are terribly vulnerable and must constantly protect themselves.
The actual reason they didn’t experience a catastrophe is that such catastrophes are typically not part of a fear or phobia. These are anxiety disorders, not catastrophe disorders. People get through the experience because the experience isn’t actually dangerous. But it’s understandably hard for people to recognise that at the time. They’re more likely to think they just had a “narrow escape”. This leads them to redouble their protective steps.
It’s the protective steps which actually maintain and strengthen the Anxiety Trick. If you think you just narrowly escaped a catastrophe because you had your cellular phone, or a water bottle; or because you went back and checked the stove seven times; or because you plugged in your iPod and distracted yourself with some music, then you’re going to continue to feel vulnerable. And you’re going to get more stuck in the habit of “protecting” yourself by these means.
This is how the problem gets embedded in your life. You think you’re helping yourself, but you’ve actually been tricked into making it worse. That’s how sneaky this Trick is.
This is why my clients so often say, “the harder I try, the worse it gets“. If the harder you try, the worse it gets, then you should take another look at the methods you’ve been using. You’ve probably been tricked into trying to protect yourself against something that isn’t dangerous, and this makes your fear worse over time.
How Can You Overcome The Anxiety Trick?
The thing that makes fears and phobias so persistent is that virtually anything you do to oppose, escape, or distract from the anxious feelings and thoughts will be turned against you, and make the anxiety a more persistent part of your life.
This is why people notice “the harder I try, the worse it gets”. They’re putting out fires with gasoline.
If you come to see that you’ve been putting out fires with gasoline, you may not have any idea what to do next. But the first step is always the same: put down the buckets. Stop throwing gasoline on that fire.
This is where the cognitive behavioural methods of desensitisation and exposure come in. They’re intended as methods by which you can practice with (not against) the symptoms, and become less sensitive to them. As you lose your fear of the symptoms, through this practice, that’s when the symptoms will fade.
All too often, people get the idea that exposure means going to a place or situation where you’re likely to get anxious, perhaps a highway or an elevator, and take a ride without getting anxious. That’s not the point!
The point is to actually go there and feel the anxiety, being sure to stay there and letting the anxiety leave first. This is what is called floating.
The way to disarm the Anxiety Trick is to increasingly spend time with anxiety, to expose yourself to the thoughts and sensations, and allow them to subside over time.
Always keep in mind that exposure is practice with fear, and do nothing to oppose, avoid, or distract from the fear during exposure.
The five steps to overcoming bouts of anxiety and panic attacks are:
Acknowledge & Accept
Wait & Watch (and maybe, Work)
Actions (to make myself more comfortable)
Let’s take a look at what each step entails.
Acknowledge & Accept
All progress starts here. This is the most important single step to overcoming Anxiety and panic attacks.
Here I acknowledge the present reality, that I’m afraid and starting to panic. I won’t try to ignore it, or pretend it’s not there. I won’t struggle to distract myself, tell myself to “stop thinking about it!”, or snap any rubber bands on my wrist.
I’m acknowledging simply that I am afraid, not that I am in danger. The thought that I am in danger is just another symptom of panic, not an important or useful thought.
Here I accept the fact that I’m afraid at this moment. I don’t fight the feeling; blame myself, or anybody else. I accept, as best I can, that I’m afraid in the same way I would accept a headache. I don’t like headaches, but I don’t bang my head against the wall in an effort to get rid of them, because that makes them worse. Overcoming panic attacks begins with working with, not against, my panic and anxiety symptoms.
How Can I Accept anxiety or a Panic Attack?
What makes a panic attack acceptable (not desirable, but acceptable) is that, while it feels awful and fills me with dread, it isn’t dangerous. It won’t kill me or make me crazy.
Accepting the symptoms, not resisting, is a powerful step to overcoming panic attacks.
What Can Anxiety or a Panic Attack Do to Me?
It makes me feel afraid, that’s what anxiety does. And, if I’m having anxiety I’m already there! I’m already experiencing the worst that will happen. I just need to ride it out. That’s the surest path to overcoming it.
Why should I accept anxiety or a panic attack? Because the more I resist anxiety and panic, the worse it gets. The more I develop the habit of acceptance, the more progress I make toward my goal of overcoming anxiety and realising that it leaves the same way as it comes in.
That’s Acknowledge & Accept. How does that compare to what you usually do during anxiety or a panic attack?
Wait & Watch (and maybe, Work)
What I mean by “Wait” is this: don’t just do something, stand there. It’s similar to the suggestion “count to ten before you get mad”.
One of the hallmarks of anxiety or a panic attack is that it temporarily robs you of your ability to think, remember, and concentrate. This step will buy you a little time to regain those abilities before you take any action.
When you react before you have a chance to think straight, what do you do? If you’re like most people, you probably flee, or struggle. You do things that actually make it worse. This is what people mean when they say things like “I know I’m doing it to myself” and the harder I try, the worse it gets.
Jumping into action too quickly is a big obstacle to overcoming anxiety and panic attacks.
So, even though you have a powerful urge to leave, postpone that decision for a little bit. Don’t tell yourself you CAN’T leave – keep that option open so you don’t feel trapped – but put off the decision about whether or not to leave. Stay in the situation. You don’t need to run away to get relief. Let relief come to you.
Use the occasion to observe how the panic anxiety works, and how you respond to it. The best way to do this is to fill out a diary. The diary is a questionnaire which helps you notice important aspects of a panic attack or anxiety, so you can respond more effectively over time. You can find a diary instruction available to download directly from my website.
My clients often report that just filling out a diary helps them to calm down. How does this work? It’s not that they’re distracted from the subject of panic, because the diary questions are all about panic. It helps you get a little distance from your emotions. It works because, while you complete a diary, you’re in the role of an observer, rather than feeling like a victim.
The best way to use the diary is to fill it out during the attack, rather than after. If you’re in a situation where writing is impractical, perhaps while driving a car, you can voice record into your phone handsfree; or pull over for a few minutes to write.
What About “Work”?
If you’re in a relatively passive situation during the panic attack – a passenger in a vehicle, getting your hair cut, or waiting in a waiting room – “Wait & Watch” is all you need. If you’re in a more active role – driving a car or giving a presentation – then you also need to attend to the “Work” of conducting that activity. Do “Wait & Watch”, but also remain engaged in your task.
That’s “Wait & Watch (and maybe, Work)”. How does that compare to what you usually do during a panic attack or a bout of anxiety?
Actions (to make myself more comfortable)
At this point, you’ve already gone through the two most important steps to overcoming anxiety.
What’s Your Job During a panic attack or anxiety?
It’s not your job to bring it to an end; that will happen no matter what you do. Don’t take my word for it. Review your personal history with it. Have you ever had one that didn’t end?
The fact is, every anxiety attack ends no matter what you do. If you respond in the most cogent way possible, and do a good job at bringing it in for a soft landing, it will end. And if you do everything the most unhelpful way possible – struggling and resisting and fleeing in ways that make the panic worse – that one will end also. Even the first bout of anxiety or panic attack a person has, when they have the least idea of what’s happening, those end as well.
When you have the fearful thoughts that it will last forever, it still ends.
So what is your job during an anxiety attack? It’s a more modest task than you probably supposed. Your job is to see if you can make yourself a little more comfortable while you wait for the attack to end. And if you can’t even make yourself a little more comfortable, then your job is just to wait for it to end.
Here are a few techniques that my clients have found particularly useful while waiting for an attack to end.
Regardless of what else you do, do belly breathing It’s also known as diaphragmatic breathing, but I think “belly breathing” is more descriptive. Many people think they know how to do deep breathing, but don’t do it correctly, so they don’t get good results. A good belly breathing technique is a very powerful tool in the work of overcoming panic attacks!
How to Talk to Yourself
Talk to yourself (silently!) about what is happening, and what you need to do. One question my clients find very helpful is this: is it Danger or Discomfort? Some of the other responses my clients like include the following:
1. Fine, let’s have an attack! It’s a good chance to practice my coping techniques.
2. Answer your “what if…?” fears by saying “So what? I’ll get afraid, then calm down again.”
3. It’s okay to be afraid.
Get Involved in the Present
People don’t panic in the present. People panic when they imagine something bad happening to them in the future or in the past. This is why your anxiety is almost always accompanied by some “what if…?” thought. The reason you say “what if…?” is because what you fear is not actually happening!
Get back into the activity you were engaged in prior to the anxiety starting, and become involved with the people and objects around you. If you’re in a store, resume shopping, reading labels, comparing prices, asking questions, etc. It will move you closer to your goal of overcoming panic attacks when you bring your focus and energy back to the present environment. By this I mean, work with what is around you.
Work with Your Body
Identify, and relax, the parts of your body that get most tense during a panic attack. This typically involves first tensing, and then relaxing, the muscles of your jaw, neck, shoulders, back and legs. Do not allow yourself to stand rigid, muscles tensed, and holding your breath. That just makes you feel worse! If you feel like you “can’t move a muscle”, start with just one finger!
That’s “Actions (to make myself more comfortable)”. How does that compare with what you usually do during an anxiety attack?
This step is here because you might start feeling better, then feel another wave of panic. Your first reaction might then be to think “Oh No, it didn’t work!”. The Repeat step is here to remind you that it’s OK if that happens. Just take it from the top again. It’s not unusual or dangerous. You may go through several cycles, and you just need to repeat the AWARE steps again, as often as you need.
How does that compare with what you usually do?
This is here to remind you that your anxiety will end; that it always ends; that they end regardless of how you respond; that it’s not your job to make it end; and that your only job is to make yourself as comfortable as possible while waiting for it to end.
Have these statements been true for you? Don’t take my word for it. Review your own history with anxiety and see.
And maybe the next time you panic, when you notice yourself thinking, once again, “Will this ever end?”, you’ll find yourself answering, “YES!” and this will relax you.
Download these 2 tools which are journal prompts and also a thought diary for you to use at your disposal to get you started and I really hope this helps you.
Love B xxxx
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