Relationships - Gaining control over anxiety
Advice on what and what not to do when one is anxious
Anxiety disorders affect a person's life and the relationships the person enjoys with family members and friends. Anxiety involves feelings of apprehension and fear characterised by physical symptoms such as palpitations, sweating, breathlessness and feelings of stress. While anxiety can be a mild and natural response to a situation, for example an imminent business presentation, it can also be a disorder. The difference is that the disorder fills peoples' lives with overwhelming apprehension and fear and may interfere with their work performance and healthy living. While we use the term anxiety in a general fashion the World Health Organisation collected various disorders under the category of anxiety disorders.
The exercises I am suggesting hereunder are useful for all kinds of anxiety disorders, whether it's a generalised anxiety, a panic attack or a specific phobia. They are designed to reduce your overall agitation level and have been found to be effective. Family members will find that to be supportive of these exercises will help relieve the stress caused by anxiety disorders and the ensuing impact on relationships.
Establish a good routine:
A reliable circadian rhythm or daily routine is very helpful. Examples of a healthy circadian rhythm include regular meal times, regular sleep and wake-up times, regular exercise, regular breaks, and so on. If you don't have a regular lifestyle you are more likely to suffer from anxiety-related difficulties, such as insomnia.
Exercise:
Exercise is one of the strongest antidotes to anxiety. Cardio-training seems to work best against anxiety. The good thing about it is that it works also in the long term because it generates helpful chemicals in the brain. Walking, running, cycling, swimming, are all effective exercises. The trick is regularity. This means that exercise has to be included into your circadian rhythm.
Learning to relax:
This is vital to balance out the stresses that are increasingly damaging our healthy living. Breathing is one of the most effective short-term anxiety antidotes. You can use breathing technique the moment you start feeling anxious or you can incorporate it into your circadian rhythm as a long-term relaxation technique. Equally, you may find yoga and meditation helpful. You can use some good new age relaxation music to help you with your deep breathing.
No matter what you choose, it is important to get really skilled at relaxing. If you are dealing with a panic attack, deep breathing may increase anxiety because you take in too much oxygen, which the body tries to correct by inhibiting the breathing reflex. Breathing less becomes the technique of choice. This means you take in less oxygen into your system. There are various ways in which you can do this. You can breathe into a paper bag and then re-breathe the air you breathe out. Sometimes this method is impractical. An alternative is called the 7:11 technique, which is breathing in to the count of 7 and breathing out to the count of 11 repeatedly. This helps in reducing the oxygen intake.
Slow down on caffeine, alcohol, and tobacco:
All these work against you and the more you consume, the worse your anxiety becomes. They are very tricky too as culturally all these drugs are associated with relaxation and when consumed can give an immediate sense of well-being and reduced anxiety. In actual fact they are stimulants and cause and increase anxiety in the long term. Alcohol also depletes the B vitamins which are important for a relaxed nervous system. A complete removal of caffeine, alcohol and tobacco is not a bad idea. But if you feel you can't give up completely then go easy.
Take action:
Become aware of what is causing the anxiety. This means you have to face the music. Avoiding it only makes things worse anyway. So if you are facing financial problems, make sure you do something to sort them out. Making a plan to resolve the problems is already an anxiety-reducing activity. Avoidance is a poor strategy because you never learn to cope, you never find out what is causing the anxiety, and because you are likely to get into the pattern of avoidance. Anxiety itself can become a physical method of avoidance.
Get a balanced perspective: Anxiety is often caused by overestimating a danger and underestimating your ability to cope with it or resolve its causes. The language you use can be catastrophic and disheartening and this makes things appear much worse. So you might think or say "we're going to lose our house, end up destitute, and there's nothing I can do about it" instead of saying "we've got serious financial problems and we need to do something serious to sort them out" (which is perfectly logical). You can regain your sense of perspective by asking others about their perspective. Talk to a trusted friend, or your partner. Remember that using extreme, catastrophic and definitive, language is very unhelpful and breeds anxiety. The balanced perspective serves to view things realistically.
One last important suggestion is to get out of the habit of worrying. The trouble with anxiety is that it can become a habit if it goes on for a long time. So even after resolving the problem you might find yourself worrying and feeling anxious about something else. This is quite a trap with anxiety and worrying. Get out of this trap by making sure you remind yourself repeatedly that the problem is solved and that you don't have anything to worry about. Undoing the habit is not easy and you need to do this repeatedly. Celebrating the successes and the resolved issues is also helpful. The trick here is to find a way to change this pessimistic part of your temperament.
While these are very helpful suggestions that really work you should always consult a relevant professional if symptoms of anxiety persist after you have tried the above exercises.
• Mr Azzopardi is a systemic family psychotherapist.
The exercises I am suggesting hereunder are useful for all kinds of anxiety disorders, whether it's a generalised anxiety, a panic attack or a specific phobia. They are designed to reduce your overall agitation level and have been found to be effective. Family members will find that to be supportive of these exercises will help relieve the stress caused by anxiety disorders and the ensuing impact on relationships.
Establish a good routine:
A reliable circadian rhythm or daily routine is very helpful. Examples of a healthy circadian rhythm include regular meal times, regular sleep and wake-up times, regular exercise, regular breaks, and so on. If you don't have a regular lifestyle you are more likely to suffer from anxiety-related difficulties, such as insomnia.
Exercise:
Exercise is one of the strongest antidotes to anxiety. Cardio-training seems to work best against anxiety. The good thing about it is that it works also in the long term because it generates helpful chemicals in the brain. Walking, running, cycling, swimming, are all effective exercises. The trick is regularity. This means that exercise has to be included into your circadian rhythm.
Learning to relax:
This is vital to balance out the stresses that are increasingly damaging our healthy living. Breathing is one of the most effective short-term anxiety antidotes. You can use breathing technique the moment you start feeling anxious or you can incorporate it into your circadian rhythm as a long-term relaxation technique. Equally, you may find yoga and meditation helpful. You can use some good new age relaxation music to help you with your deep breathing.
No matter what you choose, it is important to get really skilled at relaxing. If you are dealing with a panic attack, deep breathing may increase anxiety because you take in too much oxygen, which the body tries to correct by inhibiting the breathing reflex. Breathing less becomes the technique of choice. This means you take in less oxygen into your system. There are various ways in which you can do this. You can breathe into a paper bag and then re-breathe the air you breathe out. Sometimes this method is impractical. An alternative is called the 7:11 technique, which is breathing in to the count of 7 and breathing out to the count of 11 repeatedly. This helps in reducing the oxygen intake.
Slow down on caffeine, alcohol, and tobacco:
All these work against you and the more you consume, the worse your anxiety becomes. They are very tricky too as culturally all these drugs are associated with relaxation and when consumed can give an immediate sense of well-being and reduced anxiety. In actual fact they are stimulants and cause and increase anxiety in the long term. Alcohol also depletes the B vitamins which are important for a relaxed nervous system. A complete removal of caffeine, alcohol and tobacco is not a bad idea. But if you feel you can't give up completely then go easy.
Take action:
Become aware of what is causing the anxiety. This means you have to face the music. Avoiding it only makes things worse anyway. So if you are facing financial problems, make sure you do something to sort them out. Making a plan to resolve the problems is already an anxiety-reducing activity. Avoidance is a poor strategy because you never learn to cope, you never find out what is causing the anxiety, and because you are likely to get into the pattern of avoidance. Anxiety itself can become a physical method of avoidance.
Get a balanced perspective: Anxiety is often caused by overestimating a danger and underestimating your ability to cope with it or resolve its causes. The language you use can be catastrophic and disheartening and this makes things appear much worse. So you might think or say "we're going to lose our house, end up destitute, and there's nothing I can do about it" instead of saying "we've got serious financial problems and we need to do something serious to sort them out" (which is perfectly logical). You can regain your sense of perspective by asking others about their perspective. Talk to a trusted friend, or your partner. Remember that using extreme, catastrophic and definitive, language is very unhelpful and breeds anxiety. The balanced perspective serves to view things realistically.
One last important suggestion is to get out of the habit of worrying. The trouble with anxiety is that it can become a habit if it goes on for a long time. So even after resolving the problem you might find yourself worrying and feeling anxious about something else. This is quite a trap with anxiety and worrying. Get out of this trap by making sure you remind yourself repeatedly that the problem is solved and that you don't have anything to worry about. Undoing the habit is not easy and you need to do this repeatedly. Celebrating the successes and the resolved issues is also helpful. The trick here is to find a way to change this pessimistic part of your temperament.
While these are very helpful suggestions that really work you should always consult a relevant professional if symptoms of anxiety persist after you have tried the above exercises.
• Mr Azzopardi is a systemic family psychotherapist.