HOW CAN I MANAGE MY ANXIETY BETTER?

As we have learned, anxiety is not an illness and so can't be cured. If we can break into the vicious circle, however, we can learn ways of reducing our anxiety and getting it to be more manageable. We can work on at least four different areas:

Understanding our anxiety better.
Reducing physical symptoms.
Altering our thoughts related to anxiety.
Changing our behaviours related to anxiety.

1. Understanding Anxiety

You may now have some ideas about what is causing your anxiety (if you think that you are suffering with it).

The following sections might help you learn how to break out of the vicious circle that keeps anxiety going. Before you can do this though, it is really useful for you to understand your own anxiety better. Is your anxiety related to certain situations, places or people? Is it worse at particular times of the day? Are there realistic worries you have that would make anyone anxious? The following two exercises might help you to understand your anxiety better.

I) ANXIETY DIARY - for a period of two weeks (or longer if you prefer) keep an hourly diary of your anxiety and activity level. Rate your anxiety from 0 - 10. Note down anything that seems important. Were you at work or home, who were you with, what were you doing, what were you thinking about? You may start to become more aware of situations that make you anxious or that you may even be avoiding. What is your general level of stress like? This information will help you begin to tackle your anxiety.

II) If you become aware that you have a realistic worry or problem that you feel may be causing you anxiety, a problem solving approach may help.

A good way to begin is to write down a problem. Define it as clearly as you can. For example "I owe £3000 to different credit card companies". Next, write down as many possible solutions as you can. It doesn't matter how silly you may think the solutions are, the point is to think of as many as you can. Try to think how you have solved similar problems in the past. Ask a friend what they might do. Think to yourself what you might advise a friend to do if they had the same problem, eg possible solutions:

Get all debts on one loan with less interest
Agree on affordable payments;
See a debt counsellor;
Get a part time job;
Sell car (that's if you've got one and don't really need it).

BRIGHT IDEA ~ If you have a problem that may be making you anxious, try writing it down and then list as many possible solutions as you can, that you would suggest to a friend.

Choose what seems like the best solution and write down all the steps it would take to achieve that solution. Who might help?, what might go wrong?, often it is helpful to think "what is the worst thing that could happen?" If you can think of a plan to cope with this, your anxiety might reduce.

If you are trying to come up with a plan to tackle a problem that has been worrying you for some time, it is often helpful to discuss this with a friend or even your doctor.

Stressful Lifestyle - General Tips

Nowadays life is often stressful, and it is easy for pressures to build up. We can't always control the stress that comes from outside but we can find ways to reduce the pressure we put on ourselves:

Try to identify situations you find stressful by noticing the beginnings of tension..
Take steps to tackle what it is about these situations that you find stressful..
Make sure you have time for things you enjoy.
Take up a relaxing hobby.
Make sure you get enough sleep
Eat a well balanced diet.
Take regular exercise.
Learn to relax.

2. Reducing Physical Symptoms Relaxation

In order to reduce the severity of physical symptoms it is useful to 'nip them in the bud', by recognising the early signs of tension.

Once you have noticed early signs of tension you can prevent anxiety becoming too severe by using relaxation techniques. Some people can relax through exercise, listening to music, watching TV or reading a book.

For others it is more helpful to have a set of exercises to follow. Some people might find relaxation or yoga classes most helpful, others find tapes useful. You may be able to obtain a relaxation tape from your GP, and there are also a wide number of relaxation tapes available in the shops.

Relaxation is a skill like any other which needs to be learned, and takes time.

3. Altering Your Thoughts Related To Anxiety

We have seen the role that thoughts have in keeping going the vicious circle of anxiety. Sometimes there may also be pictures in your mind. To give an example, imagine you are running for a bus one day. All of a sudden you get a pain in your chest and feel really breathless. The thought goes through your mind, "I'm having a heart attack". This thought is of, course, very frightening, and so your heart starts to beat faster which makes you think "there really must be something wrong with my heart". You may very well have a picture of the ambulance on its way and you in a stretcher.

It isn't always that easy to know what you are thinking that is making your anxiety worse. The sort of thoughts that make people anxious can come and go in a flash, and may be so much of a habit that they are automatic. They may be so familiar that they just feel like part of you.

Try to keep a diary over the course of two weeks. Write down your own thoughts in situations where you are anxious. Now, try to imagine the last time you felt very anxious. Try to run through it like a film, in as much detail as you can. See if you can write down any frightening thoughts now.

Remember any thoughts can count. No thought is too small or too silly. Even "oh no" or "here we go again" can increase tension and anxiety. Once you know what it is you are thinking, you can begin to fight back, and break the vicious circle.

In Particular, Ask Yourself:
1. Am I exaggerating, eg "everything is bound to go wrong it always does".

2. Am I jumping to conclusions, eg "I have a pain in my chest therefore it must be my heart".

3. Am I focusing just on the bad things, eg "I had a really bad day yesterday" (ignoring that this followed a few good days).

Use these questions to help yourself answer back. A good way of doing this is to write two columns - one for your thoughts that make you anxious, and the other for a more balanced thought, eg:

ANXIOUS THOUGHT The dizzy feeling means I'm going to faint. I'm going mad

BALANCED THOUGHT I have had it many times before and have not fainted. I have fainted once and that felt really different I have not gone mad yet, and the doctor tells me anxiety is not madness.

Write down some of your thoughts now and write as many answers as you can. This question might also help. What would you say to a friend who was thinking that way? The aim is to get faster at "catching" these anxious thoughts and answering back almost instantly. It takes a lot of practice, but really does work.

4. Changing Behaviour Related To Anxiety

Try to recognise when you are avoiding things and wherever possible try to tackle these fears, not all at once but in a gradual way. Set yourself very small goals.

People often get into the habit of escaping from situations that make them anxious. Instead of escaping try gradually to increase how long you stay in a situation that makes you anxious. Anxiety often reaches a peak, then starts to go away naturally. If you stay in an anxious situation what do you predict will happen to your anxiety? People often think it will just keep getting worse and worse. This is not the case. It will start to come down.

People not only avoid situations and try to escape, they also often do things to make themselves feel more safe, eg hanging on to a shopping trolley, lying down. These "safety behaviours" may help at the time, but they also help to keep the anxiety going because the anxious person never learns that nothing awful would have happened even if the trolley wasn't there. Also, imagine how frightening it would be if no trolley was available.

Try to do things to test out whether your anxious thoughts are realistic?, eg "would I really faint if I didn't get out?" It really is very important to recognise that the more you avoid something, the more difficult it will seem to overcome, which will in turn make you more anxious.

What Treatment Is Available For Anxiety?

Some people with anxiety can benefit from self help such as a website, books, leaflets, Cds etc.

Your family doctor, health visitor or practice nurse may also be able to give you further help in dealing with anxiety.

Occasionally, doctors prescribe tablets for anxiety. These should only be taken for short spells to get over specific anxiety provoking situations.

Your doctor may also refer you to a mental health worker or counsellor if your anxiety does not respond to self-help alone.

Anxiety Management Groups or classes are often run in local surgeries or Community Health Centres.