It is important to consider the difference between prevention and treatment. I’m going to give you some ideas of things you can do as preventative measures as well as actions you can take if you find yourself in the middle of a panic attack. Each person is different and will find that certain techniques either work or don’t work for them. However, the first step in coping with anxiety applies to pretty much everyone: take care of yourself.
Self-care involves the basics that you’ve probably heard a million times. For example, consider your eating habits. Try to eat well – lots of fruits and veggies, whole grains, and quality protein – and drink plenty of water. Cut out caffeinated drinks like coffee, tea, and energy drinks. If you suffer from anxiety, caffeine is going to make it worse.
Be active and get some exercise. Moving your body will help expend some of your anxious energy and help to tire you out to get a good night’s sleep. Getting quality sleep helps to decrease feelings of anxiety. If, however, you are struggling with a busy mind that keeps you up at night, start a journal and write down your worries and concerns. If this isn’t enough to slow the spinning wheel that is your mind, then work on figuring out some problem solutions to help you put these thoughts out of your head, at least while you sleep. Make sure you give yourself enough time to do this before bed so journaling doesn’t become another thing that is preventing you from getting enough sleep.
Try to focus on being positive. When we get caught in a negative frame of mind we can quickly descend to a bad place where little stressors can feel out of control. Also, positive people are less likely to feel anxious. It can help to focus on the here and now and not allow yourself to be pulled into “What if…?” questions that are likely part of your anxiety. This might be easier said than done, right? Start by getting rid of the words ‘always’ and ‘never’ from your vocabulary. If something isn’t going your way, look at the specifics of the situation and be clear about what the problem actually is. Try to shift your frame of mind to thinking that a setback or problem is temporary, be aware that ongoing effort may be necessary for change to take place, and also be realistic in your goals for change. Learn the difference between planning for the future and futile worry. That being said, sometimes a situation may be out of your control and it is important to try to accept what you cannot change.
Focus on making little life changes, small steps in your self-care routine that will be easy to manage. These steps will eventually make a whole lot of difference to the way you feel.
A big step in coping with anxiety is recognizing what things cause you to feel anxious. This might include people, places, activities, or experiences. These are what I will call your triggers. I’m a big fan of lists and writing things down, so if you feel like pausing right now to do that, go for it, I’ll wait. We can keep going with this list and begin to explore what symptoms your triggers elicit for you, otherwise known as your anxiety reactions. Knowing your triggers and your reactions will help to prepare you for the next step, which is discovering what coping mechanisms work best for you.
Part of your personal anxiety exploration may also include looking at the sensations of anxiety and accepting that the actual physical symptoms of anxiety are not in and of themselves harmful, though they might feel horrible. In general, it is the symptoms of anxiety that we want to avoid but even if we are successful, simply reducing these symptoms won’t solve the issues that will still be there bubbling below the surface. In fact, many of our coping techniques are training us into a pattern of avoidance and insecurity. We need to look at our anxiety in a different way and consider prevention as well as healthy symptom treatment.
Challenging the thoughts and beliefs about anxiety and different situations can sometimes be enough to decrease symptoms of anxiety. However, when in the grip of a difficult situation, we may not be thinking as clearly as we could be. An inherent aspect of anxiety is the exaggeration of issues to be out of proportion with reality. Writing down your thoughts can help provide you a sense of clarity, as can speaking to someone about what is going on for you. I call this action reality checking. Once your thoughts are put down on paper or are out in the open, you can begin to track and test those thoughts and then focus on creating more realistic views of experiences. I would sincerely recommend working on this sort of reality checking with a trained therapist or counsellor.
It can be difficult to talk about issues because it is very exposing. However, talking through your problems with a trained professional is very different from talking to a friend or family member. Although having a support group within your social circle (family, friends, coworkers etc.) is very important, sometimes the suggestions offered can be less than helpful and comments might feel discouraging or upsetting. Some people in our lives may also not want us to change because it could disrupt a way of life that they have become used to. The purpose of therapy, however, is to provide a safe space that allows you to explore the problems in your life without judgment and, ultimately, help you to work towards a happy, healthy life.
As I mentioned in an earlier post in this trilogy, in addition to day-to-day problems, anxiety can also stem from problems from the past and, if so, will require exploring the deeper origins of your anxiety. Sometimes it can be difficult to make the connections between what is going on for us today with what has happened before, but it is important to deal with bad experiences to help us move forward. Other techniques that might require the help of a therapist or mental health practitioner may include deep breathing and Progressive Muscle Relaxation, visualization, and thought stopping.
Sometimes the power of deep breathing is underestimated. I think this is likely because we all breathe, even when we aren’t thinking about it (I bet you’re even doing it right now!). A mistaken thought might be that if we breathe automatically, how different could breathing for relaxation really be?
The lungs are like two balloons that fill up with air, providing oxygen to the blood, which feeds our brains and organs. Not breathing deeply or evenly enough can mean that we aren’t oxygenating our blood efficiently, which can make our anxiety feel that much worse. It also means that we aren’t using our lungs effectively or to capacity. So, while we’re still breathing, our method of breathing is actually contributing to our problematic anxiety.
Breathing patterns associated with feelings of anxiety generally involve short, shallow breaths that are often irregular and from the upper chest. We call this ‘overbreathing.’ The opposite of this is diaphragmatic breathing, which is how we breathe when we are asleep (and, of course, don’t have a condition such as sleep apnea). This kind of breathing is even and regular and when we breathe in this way we are much less likely to experience the symptoms of anxiety associated with overbreathing.
Like most things within our body, we function best when we have balance. In the case of breathing, that involves a balance of oxygen and carbon dioxide. Overbreathing causes an imbalance in these chemicals in our bodies. This chemical change impacts both our brains and our bodies and can be responsible for a number of the symptoms of anxiety that we feel, such as dizziness and lightheadedness, as well as feeling hot and flushed, experiencing muscle stiffness, and cold clammy hands. As I said earlier, these anxiety symptoms themselves are not actually dangerous. However, they can often be precursors to panic attacks.
Learning how to control our breathing means that we can bring our bodies back to that desired chemical state of equilibrium, and will help us to reduce the physical symptoms of anxiety and facilitate relaxation (which is pretty much the opposite of feeling anxious).
Here is a breathing exercise that you can use if you find yourself in the grip of anxiety. Let’s practice it now.
I’d like you to get into a comfy position. The first thing I want you to do is to press the tip of your tongue to the ridge behind your teeth. I want you to try to keep it there while we do this (it is a bit of a coordination exercise). I want you to close your eyes… Well, maybe read through this first, at least once… Put your hand on your tummy to see if you feel it expand and contract as you breathe. Next, through your nose, I want you to take a nice, deep breath in for a count of 7. Try to fill up your lungs with each breath in and allow your stomach to expand (don’t worry, no one is watching, just relax and let it all hang out). Now I want you to hold that breath for a count of 4. Then, breathe out through your mouth (still trying to keep the tip of your tongue on the ridge behind your top teeth) for a count of 8. In for 7, hold for 4, out for 8.
Try this three times now.
How do you feel?
Now try doing this technique for 5 minutes.
When we breathe in through our nose, we are more likely to engage in diaphragmatic breathing, which is calming. This breathing exercise is something that you can do every day. In fact, if you suffer from anxiety, I’d recommend that as a minimum you take 5 minutes in the morning and 5 minutes at night to practice this exercise. This might feel like work for you, especially if you haven’t been doing much diaphragmatic breathing lately. But practice is key to helping to regulate your normal breathing pattern and ultimately help you to calm yourself when faced with a stressful situation by decreasing some of your unnecessary physical symptoms of anxiety.
Here is another part that I think is just as important to consider when trying to cope with anxiety: What NOT to do.
When we find ourselves in the midst of issues that feel too large to cope with, it may feel like problems can spiral out of control. However, ignoring them, avoiding them, or running away will not reduce the stress but may actually make things worse. Since the problems won’t just go away, instead of hiding from them try to work through them as they arise so that they don’t begin to pile up on you. If a problem is time sensitive, ignoring it will only make you feel that much more anxious as the internal ticking clock counts down. Don’t put off what you can do today, even if doing so feels a bit like torture. If the problem feels insurmountable, break it down into pieces or steps that are more manageable and prioritize these so you focus on the most important part first.
It is possible that medical treatment might be necessary. If you feel this is the case, I’d encourage you to speak to your doctor in order to get a referral to see a qualified professional who can assess your unique situation and work with you to find an appropriate medical treatment. That being said, and when working with any professional, don’t be afraid to ask questions; get the information you need in order to feel comfortable with your treatment. This is your right.
What becomes problematic is when someone tries to self-medicate to provide a quick fix to the problem. This can often lead down a dangerous path (there is a significant relationship between individuals who abuse/misuse substances and an increased rate of social phobia). Using alcohol and/or drugs (both street drugs and abuse of the prescription kind) to escape the feelings of anxiety can actually make anxiety worse. The substances that we use to self-medicate can disrupt our body chemistry and our sleep and really, waking up with a hangover can only make going about your day that much more difficult. Alcohol and drugs can also damage your health and give you an additional source of anxiety.
Smoking is another form of self-medication. In spite of the rumour that smoking can help with relaxation, cigarettes actually increase your heart rate and make anxiety worse. Plus, if this is your chosen method, ask yourself how relaxed you’ll feel if you’re stuck somewhere that smoking isn’t allowed? Instead of smoking, try to find self-soothing techniques that can help reduce anxiety as it arises. A stress ball, for example, can be surprisingly therapeutic.
Early diagnosis and treatment for anxiety disorders is important. Unfortunately, many individuals don’t seek help. In some ways, this is understandable – for example, social phobia involves a fear of speaking to individuals of authority and fear of embarrassment, and may involve feeling a sense of shame around experiencing anxiety. For someone struggling with social phobia, seeking help could initially cause an increase in the experience of the problem for which they are seeking help. However, with time, effort, and support, the bad feelings will be replaced with a sense of success and growth.
Even if it feels as though you are alone in your anxiety, you don’t have to face your problems by yourself. Please don’t be afraid to speak to someone if you are feeling that life is getting in the way of living.
Here we are at the conclusion of this trilogy on anxiety. We’ve laughed, we’ve cried, it has been a wild and anxious ride, thank you for going on this journey with me. In addition to giving you information about anxiety, it has been my goal to help you organize a sort of anxiety ‘tool box’ with different tips and techniques that you can use the next time you start to feel anxious. Remember to go at your own pace and to look at what you want your life to be like.
Wishing you all good mental health, I’m here if you need me.