24th March 2019


What is anxiety?

We all experience anxiety from time to time but when someone finds that they are feeling anxious for most of the time this can become a mental health problem.  Anxiety affects our whole being.  It is a psychological, behavioural and physiological reaction all at  once. On a physiological level, anxiety may include bodily reactions such as rapid heartbeat, muscle tension, dry mouth, feeling dizzy or sweating.  On a psychological level it produces apprehension and unease.  You may feel detached from yourself and a fear of dying or going mad is common. On a behavioural level it can impede your ability to act, express yourself or carry out certain everyday tasks.

Anxiety is an inevitable part of modern life.  It is important to know that there are many situations that are appropriate and reasonable to feel some anxiety.  For example taking an exam, performing in front of an audience, getting lost in a foreign country and not speaking the native language or learning that a loved one has been involved in a terrorist attack.  If you do not feel any anxiety at all in these types of situations then something may be amiss.

Triggers of anxiety

The most common behavioural reaction is avoidance which, although can provide a short term solution, in the end, heightens anxiety.  The problem about avoidance is that we never confront whether the fear that we are anxious about would actually happen.

'Self-talk' is what you say to yourself in your own mind.  It is the internal monologue that you engage in much of the time, although it may be so subtle and automatic that you don't notice it.  "What if" thoughts can create much anxiety. Examples may be "what if I crash the car when driving?" or "what if people notice that I am anxious and will think that I am stupid and laugh?" "What if I get so anxious that I have a heart attack?"  These thoughts anticipate the worst before it happens.

Negative thoughts can appear to arise out of nowhere and seem automatic.  These unreasonable thoughts are not an attempt to reason, develop a logic pattern or to resolve the problem but rather these thoughts are usually inaccurate, unreasonable but feel plausible at the time of experiencing them.  For example, "I have a pain in my stomach, it might be cancer, and  if it is cancer I will die".   Almost all our conscious life we engage with internal thought language.  These are thoughts which interpret our world.  If the self-talk is accurate and in touch with reality then we function well. If it is irrational and untrue we usually experience anxiety and emotional disturbance. For example some people will believe that "I can't bear to be alone."  However, no physically healthy person has died from merely being alone.  Being alone may be uncomfortable, undesirable and frustrating but you can learn to live with it.

Negative self-talk derives from false beliefs about yourself, others and the world.  A mistaken self belief could be "I can't be on my own and always need someone to be with me."  "Life is dangerous and I must not take any risks or life is  a struggle and people always let you down so I can't trust anyone".

Withholding feelings such as frustration, sadness or even excitement can contribute to anxiety.  For many anxiety sufferers, anxiety is their main accepted emotion and may be a mask for other feelings that may not have had the same permission to be felt and expressed.  Often letting out your angry feelings in a healthy way or having a good cry can help you to feel better, calmer and more at ease.

A lack of self-nurturing skills are common-place for anxiety sufferers. If you have not received good enough nurturing on a consistent and reliable basis it is normal that sufferers do not know how to look after themselves well, and properly take care of their own needs and, dare I say it, to love and esteem themselves.  This lack of self-nurturing skills only serves to fuel anxiety.

Body tension restricts our breathing and if our breathing is shallow and restricted this will increase our anxiety. Poor breathing and thinking "what if" thoughts and catastrophising is a sure way to feel anxious and if we keep doing this we will experience anxiety.

Stimulants such as caffeine and nicotine can aggravate anxiety as well as cola drinks, sugar and other food additives. Living a high stress lifestyle and packing in lots of activities every day and not stopping for rest or making rest times imperative after a particular high stress period can also trigger anxiety.  It is like running an engine in a car without servicing it - eventually it will refuse to function.

Accept the anxiety and learn to welcome it rather than trying to get rid of it.  If you try to avoid it then you are in fact prolonging the unpleasantness of it.  However, it is important that you don't make it responsible for how you think, feel or act. An anxious person usually wants either to avoid or fight anxiety symptoms.  The problem with this is that once the anxiety reaches a certain level the person can no longer control the symptoms.  However, if you give up the idea of controlling the anxiety you can learn how to manage it differently.

Act when you have anxiety and normalise the situation.  In other words act as if you are not anxious.  In order to do this it is important to beathe slowly and normally.  Hyperventilating, that is breathing too quickly or too deeply or too shallowly will produce anxiety-like symptoms, which will cause a chain reaction.  If you avoid the situation that is worrying you your anxiety will decrease but your fear of it will increase.  If you confront the experience both your anxiety and fear will in time reduce.

Expect the best. What you most fear rarely happens. Your catastrophic fantasies are usually far worse than the actuality. However, don't be surprised if next time you have a similar situation to face you may still experience  anxiety.  It is not about getting rid of anxiety but rather learning how to manage it.

Strategies to manage anxiety differently

Relaxation is an effective technique where a person can discover mastery over their anxiety by relaxing their body and clearing their mind from unwanted negative thoughts.  There are many excellent CDs and 'Apps' to help you master this or you could join a yoga or pilates class. Regular practice of breathing exercises, regular aerobic exercise and nutritional improvements in your diet are also important.

Structuring the day can be very important for many who suffer from anxiety as they find the most basic tasks such as showering, dressing, cooking and shopping as problematic.  People with such high anxiety will normally benefit from planning their daily activities in detail.  This schedule provides the sufferer with a sense of direction and control and a distraction from anxiety and anxiety-producing thoughts.

Tolerance of anxiety is imperative for the chronically anxious person to confront the anxiety-proving situation. In other words the person says, for example, "I am strong enough to do this" rather than "I can't do this".

How to Manage Negative thoughts
  •  Identify negative thoughts
  •  Learn how to challenge the validity of these negative thoughts
  •  Change negative thoughts to more constructive thoughts that will reduce anxiety
  •  Learning how to breathe well to manage anxiety is imperative
  •  Learning distraction techniques to distract yourself from feeling anxious and thinking negatively

Examples of distraction techniques are singing, taking exercise, dancing, watching a good feel DVD or your favourite TV programme or a comedy programme, going to the gym, gardening and cooking are all examples of what can help some people to distract themselves from their fear.  It is almost impossible to sing, laugh or hum and at the same time feel anxiety!

In my next Blog I will discuss Panic and how to deal with it.