Free Yourself from Anxiety (4 page)

Dealing with most health problems involves a degree of self-help. Even something as simple as remembering to take your tablets is self-help. Someone with a joint injury may be given exercises to practise at home, a diabetic will be given dietary rules, or a heart patient will be given lifestyle advice.

In the case of Anxiety disorders, the self-help element is crucial. The best therapist in the world can’t help you if you don’t co-operate with them, and drugs will only dampen the symptoms down to a level where you feel able to do the work that’s needed.

Every time you talk your problems through with a sympathetic friend or family member you are helping yourself. Reading around the topic will help you to understand your illness. In some areas there are self-help groups, where people meet up to socialise and offer support to each other. Finally, there are the telephone helplines, run by volunteers who are almost all sufferers themselves – see Appendix 2 for more on these.

So whatever treatment route you choose, self-help will be involved. This book, however, offers you a complete approach to self-help. You can use it entirely on your own, or in tandem with other help – but do please mention to your therapist that you are using it.

Qualities needed for self-help

Anyone can apply the principles of self-help. It doesn’t matter if your Anxiety is mild or severe, new or long-standing. There is always
something you can do to start yourself on the road to recovery. What personal qualities do you need?


Commitment:
you may be at the stage of researching your options, with the intention of leafing through this book to see what it’s like. That’s fine, but when you are ready to start work it’s best to do so with the determination to give it a fair chance.


Time:
you will need to set aside some time every single day for working on your recovery. The amount of time needed will vary from person to person and many of the tasks you undertake will not be too demanding, and may even be pleasurable.


Patience:
there is no miracle cure or magic wand for Anxiety, and in the early stages your progress may feel painfully slow. If you stick with it you will find that you do make progress and it does get easier.


Motivation:
how badly do you want to be free of your Anxiety disorder? That is what gives you motivation, and our experience shows that most sufferers have plenty of it.


Courage:
you probably don’t feel courageous at the moment, but just stop and think. How hard is it to face every day knowing that you might have a panic attack, or that your phobia will haunt you, or your OCD will dominate every moment? Doesn’t that take some courage?


Support:
many people don’t like to admit to having an Anxiety problem, but if you can find someone to support you it will help you through the difficult patches. In Chapter 25 we will give some advice that shows your chosen supporter the best way to help you. An alternative is to make use of one of the helplines that exist for just this purpose – phone numbers are in Appendix 2.

Questionnaire – are you ready for recovery?

How committed are you to recovery?
A bit/quite a lot/100%

How much time can you give each day to the work?
Very little/30 minutes/at least an hour

Are you prepared to wait a while for the results to show?
Yes/No

How do you feel about living with an Anxiety disorder?
Not bothered/fairly unhappy/find it unbearable

Are you ready to face up to what needs to be done?
Yes/No

Have you found a source of support?
Yes/No

Perhaps you found these questions annoying. Did you want to shout ‘of course I’m committed and motivated, just show me what to do’? Good. We don’t mind if you get angry with us – anger gives you energy, just what you need right now.

Perhaps the hardest thing for many Anxiety sufferers is simply finding the time for a recovery programme. Many Anxiety sufferers are very busy people, juggling family commitments, work and Anxiety in one endless rush. Others are kept busy by their Anxiety – OCD in particular can be very time consuming.

It will be difficult to find enough time at first, but gradually you will turn things around, life will be less fraught, and you will have more time available.

GROUP MEMBERS TALK ABOUT MOVING TOWARDS RECOVERY.

‘I just felt relieved. I absolutely believed it, because I knew they’d done all the tests.’
B
RIDGET

‘I kept going back to the hospital for various things, and eventually I did accept the diagnosis of anxiety.’
J
ULIE

‘As I sat in the Accident and Emergency waiting room … the situation began to sink in. Here I sat, an acute agoraphobic, prone to panic attacks, unable to walk beyond my own street and I had dealt decisively and efficiently with an emergency. Now, of course, I was wondering how the devil I was going to cope with getting home. It was an extraordinary switch from complete confidence to impending panic


M
ARGARET

‘If it were humanly possible to remove every ounce of anxiety from an individual, that person wouldn’t survive for very long.’
N
ORMAN

‘My brother died three hours after our mother’s funeral. No one was expecting it, we thought it was just a kidney infection. And my boyfriend died in my arms – he had cancer. When these things happened, they didn’t make me anxious, they made me stronger. When you’re tested like that it’s as if someone else takes over and you get through.’
W
ENDY

Key skill – goal setting

Recovery work for Anxiety is based on setting and achieving goals.

Goals need to be realistic

Are you an impatient person? Do you want to rush in and do everything we suggest in the first week? You’ll need to curb your enthusiasm. Taking on a goal that is too big for you will lead to failure, and you will feel like giving up. Always make goals small enough that you have a good chance of succeeding. Are you inclined to be over-protective of yourself? In that case, you may need to brace yourself and take a little more risk. Goals that are too small don’t provide any challenge and achieving them doesn’t bring any reward.

Choose specific goals

Don’t say ‘my goal is to be happy’. Do say ‘my goal is to stop counting my coat hangers’ or ‘my goal is to post a letter’.

Break goals down into small steps

The answer to both the above difficulties is to break goals down into small steps. Start by choosing an overall goal and then see what smaller goals you could set to help you towards it. The smaller goals can also be broken down – there is an example of how to do this below.

Keep a record of goals and progress

Use your notebook to record the goal and the steps.

Learn from your failures

Counsellors and therapists say that failures are more useful than successes because we learn so much from them. If you fail at one of your goals, don’t let yourself plunge into despair. Instead be your own counsellor and try to analyse why you failed – this is the problem that you need to overcome. Rearrange the goal so you have a better chance of success next time.

Repeat your goals

Try to do each goal more than once. Overall it will get easier each time, although there may be the occasional setback.

Example of goal setting – running the marathon

We will give examples of goal setting for Anxiety recovery later on, but for now let’s look at an example that has nothing to do with Anxiety. A very unfit person decides to run the marathon to raise money for their favourite charity. A trainer helps them break down their goals.

Main goal

Run the marathon.

Secondary goals

1. Run a mile.
2. Run 5 miles.
3. Run 10 miles.
4. Run a half marathon.

And so on to the actual day of the marathon.

Breakdown of first goal

Since this person is very unfit, there is no way they are going to run even a mile the first time they go training, so they have to work out a series of mini-goals.

1. Walk half a mile on the flat, repeat until comfortable.

2. Walk a mile on the flat, repeat until comfortable.

3. Walk half a mile uphill, repeat until comfortable.

4. Walk a mile uphill, repeat until comfortable.

5. Jog a few yards on the flat, repeat until comfortable.

And so on until they can run a mile.

When setting goals, use the acronym SMART and make your goals:

S = specific (something you can know for sure you’ll manage)

M = measurable (something you can rate for success)

A = achievable (something within your ability)

R = relevant (something you want to achieve at this time)

T = timeable (something you can achieve in a specific and short period of time).

Key skill – learning to relax fully

Once you have your tape or CD, or have recorded your own, it’s time to start using it. Arrange a time when you won’t be disturbed – if there are other people around, explain that you need to be alone for a while. Take the phone off the hook, switch off your mobile.

Lie down, or sit in a comfortable chair, and listen to the recording. Don’t try to judge how much you’ve relaxed, just let it happen. If you fall asleep, that’s okay. You can always set an alarm if you need to be up and about at a certain time.

Do this every day. If you are very anxious, do it twice a day, morning and evening. If the recording helps you sleep at night, then use it for that, but don’t count that as your session for the day.

Some people find it hard to get started and feel anxious about doing relaxation. Here are some tips:


The first time you play it, don’t try to relax, just listen normally and get used to the voice and the words.


If you feel very tense and can’t sit still while it is playing, then make it your goal to let it run through to the end – anything so long as you play it at least once every day.


Don’t judge yourself if you’re finding it hard to relax – some people do, some don’t, it’s as simple as that.

While you’re getting used to relaxation, be prepared to play your recording once or twice a day for at least three weeks. This is to give it a fair chance. It’s worth persevering because relaxation is such an important part of recovery.

Once you’ve formed the habit of doing relaxation every day, keep it up throughout your recovery programme.

GROUP MEMBERS TALK ABOUT RELAXATION

‘I do relaxation, I use a CD that the therapist gave me, it has a guided visualisation on it. It sends me to sleep.’
A
NDREA

‘I don’t use relaxation. I’ve tried it, but I’ve never developed the discipline. I’ve always found it hard making the time for it.’
A
NDREW

‘For a long time I used a relaxation tape, but now I am so familiar with the routine that I can relax myself without a tape. I used the tape 2–3 times a day. I relax in a conscious way at bedtime when I turn the light off. Otherwise whenever I’m aware that my body is tense which would be once to twice a day.’
J
ULIE

‘Regular practice in relaxation techniques … helps you to differentiate between levels of tension and relaxation. If you can recognise when periods of tension appear you will have time to do something about it, before it does something about you.’
N
ORMAN

‘I did practise relaxation while I was in hospital, not so much now although I do use it when I need to. However, I go to local MIND group and they are doing some relaxation. I have some tapes and do some meditation. I’ve done guided imagery with my therapist but didn’t find it so relaxing. I did some aromatherapy and Reiki which were good.’
S
ARAH

‘In the past I’ve used the progressive muscle relaxation from No Panic, and I do self-hypnosis relaxing all my muscles and it sends me off to sleep.’
W
ENDY

Anxiety is experienced by virtually everyone at times. It is a normal and natural feeling when facing situations which are unusual, challenging or risky.

We are all likely to encounter events in our lives which produce anxiety. These may be major such as the death of a close family member or severe financial problems. They can also be the more normal changes which are part of life: changes at work, home or in one’s social network. Even going on holiday or preparing for Christmas can involve a measure of anxiety.

A small amount of anxiety is healthy and useful if you are facing something difficult. It helps you to take better care of yourself in a dangerous situation and it can help you perform better, for instance in an exam or public performance.

Abnormal Anxiety is different. It can make you feel excessively afraid in situations that are not stressful or threatening to most people. It can give you such a high level of Anxiety (or nerves) before an event that it stops you thinking or acting in a constructive way.

Anxiety disorders are an extreme development of abnormal Anxiety. If you have an Anxiety disorder, then your anxiety will:


be more intense than normal


last longer than normal


lead you to behave in ways that interfere with your normal life.

How do anxiety disorders develop?

There are various reasons why people develop Anxiety disorders but most sufferers, when they look back, can see that there was a period of stress in their lives that acted as a trigger. In addition, they may feel that they were always nervous, right from childhood, or always tended to worry about things.

Some stages in life seem to make us particularly vulnerable. Adolescence is an obvious one, but many young people seem to go through a difficult time a few years later, shortly after they first leave home. Perhaps life suddenly seems all too serious, with the need to be financially
self-sufficient
, to look for a partner, and generally establish yourself in the adult world.

But stressful events can strike any of us at any time, and if there are enough of them any one of us can be vulnerable to Anxiety. The
Holmes-Rahe
Scale was devised to measure stress levels. It is interesting to note that even a pleasurable event such as getting married causes a measurable stress, and could contribute to an Anxiety problem.

Task – measure your stress

Here is a list based on this Scale, and you can use it to measure your stress level. Think back over your life in the two years leading up to your first experience of panic, phobia, obsession or GAD and tick any of the items that you experienced. Add up your score – if it comes to more than 150 then you have experienced more than average stress, and if you score more than 300 then you’ve had a lot of stress.

Don’t dismiss this. People will often say ‘yes, but I should have been able to cope’. There is no should about it.

GROUP MEMBERS TALK ABOUT THE BUILD-UP TO ANXIETY

‘I had a “naughty” magazine which was not unreasonable for a boy of 11. I knew I should not have it so I would hide it. But being so scared it would be discovered I found that I had to keep going to it to make sure it was there, to make sure that I had actually hidden it.’
A
NDREW

‘At the time there were some concerns around my blood pressure and I was feeling quite anxious about it. I was under stress at work.’
B
RIDGET

‘My first bout of anxiety was triggered by a relationship break up – I suffered from depression first and then anxiety followed.’
J
ULIE

‘Our eldest son … developed acute bronchitis … my husband was having regular attacks of fever. I was walking home alone … the road seemed to be undulating … heaving like the waves of the sea … the garden walls were leaning towards me …my heart started to beat rapidly … my vision was becoming blurred … there was a thumping beat in my head and I couldn’t breathe.’
M
ARGARET

‘There was a long slow build up to my first bout of anxiety. Four years before I had a severe ear infection that led to balance problems, which was very frightening and went on for 10 months. This was followed over the next couple of years by my degree finals, a divorce and worries about getting a job.’
P
EN

‘I know now that it all started at the dentist when I was 13, I wasn’t scared of the dentist but they locked the door, and I panicked, they pushed me down on the chair and three of them held me while they put the gas mask on my face.’
W
ENDY
 

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