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You can also ask someone else to read it to you or record it.

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. If you have a particular phobia which you do not think is covered here, you may find it listed on The Phobia List website (see Apdix 2). Do you avoid the dentist, or dread the thought of an injection? Choose specific goals Dont say my goal is to be happy. Start the breathing as early as possible, so that you go into the situation calmly. These are explained in Chapter 2 Anxiety/Panic Disorder This is the form of the disorder that brings on sudden attacks that paralyze you with fear for no apparent reason. These things are not easy, and for some people retreat into Anxiety can seem like their best option. Go for a longer drive in traffic with helper driving. What is the evidence for this thought being true? A similar process haps if you are frightened. Write down in your notebook exactly what you intend to do, and what you expect the outcome to be for each of the two theories: Example: Test: I wont do my cleaning ritual in the living room for one day. Next are the cognitive distortions that weve already looked at, everything from all-or-nothing thinking to wishful thinking. No wonder its hard to pick yourself up and find the energy for a recovery programme. Repeat each step until you are comfortable with it. Go camping in Spain. Are you one of them? Many studies have focused mainly on two specific portions of the brain that are responsible for inducing feelings of fear and anxiety. So I dont use exercise as a recovery tool, but it does help me to maintain good mental health. Exercise helps. It doesnt matter how many good things have come your way, there will always be a but as you knock back the good and focus on the bad.

Clench your fists.

Just anxiety. The person I presented to family and friends could not do certain things because of anxiety and panic but the burden I was carrying within my head was far heavier and much more horrendous to me. Learning about Exposure Work The basic tool that is used in CBT for changing behaviour is Exposure or systematic desensitisation. Keep a record of your Anxiety throughout the test, so that you can trace how it peaks and then starts to die away. I catastrophise, underestimate my ability to cope, filter out the positive. I used to catastrophise, but I dont now. Specific phobias These are also known as simple phobias because they focus on just one thing. Your fingertips will move apart as you do this. The great original affirmation is every day in every way I am growing better and better. It can feel pretty silly to look in the mirror and repeat this sort of thing, but all we can say is, it does work, so do it. Just thinking about it makes it go haywire. I have worked on my breathing – its the most important thing for me. Go camping in Spain. Start with the negative core belief, for instance Nobody likes me. Thoughts about germs may lead to compulsive hand washing or cleaning. This could be a relationship or a job that makes demands or imposes structures that they just cant cope with. The next step is to see what changes you can make to improve matters. Or vice versa. You can see for instance that a child who loses a parent might comfort themselves by thinking its not my fault, all adults go away sooner or later, or they might take the exact opposite view and blame themselves – its all my fault that they went away. Greek plays always aimed to send people home feeling better in this way – even a tragic play or film, while sad at the time, produces a feeling of release and catharsis afterwards. I always greeted Pat when I passed him on my way out or on my return. If you are afraid of flying, you wont be able to get on a plane every day. In other words, some people find that recovery ultimately deds on finding a broad purpose or direction to give their life greater meaning. What will the doctor do?

You have to understand that when a person is actually going through an Anxiety attack rationality is not something they are concentrating on.

Enjoy the garden, if you have one. Breathe in and allow your stomach to expand like a balloon as you fill your lungs with air. There is more about this in Chapter Your digestion may be affected, with loss of appetite, dry mouth, nausea, swallowing difficulty. Sometimes people worry about how they are going to explain what they are feeling. Is this belief always true? All three types of thought can be challenged with counter statements. Facing up to difficult issues Once you have worked out what it is that you find difficult to face, you can decide if theres anything that can be done about it. Its long and tough but at last you get it out, and now you know that dandelion wont be growing back in your lawn. Ways of using this book You may feel ready to undertake the challenge of working towards a full recovery. I am a critic, I laugh at myself. Once youve formed the habit of doing relaxation every day, keep it up throughout your recovery programme. Rather like putting Anxiety on trial, this is a way of shining a light onto it and understanding how it works. I have general anxiety due to withdrawal from tranquillisers. I have suffered from OCD most of my life. In the end my diagnosis was panic attack.Ive had panic, agoraphobia, death phobia, social phobia, illness phobia and claustrophobia. [I] could not shake off the feelings of dread . However severely restricted you are, starting from where you are now, you can make improvements in your situation. Say I wont be able to give anyone a lift on Tuesday evenings, thats going to be my evening off. Breathe out. Lift your shoulders towards your ears and breathe in. Breathe quietly, and focus on the word relax. Most people who experience traumatic events such as road/rail/air accidents or incidents involving violence can expect to have at least some disturbing physical and emotional reactions associated with shock and horror.

dirt and washing – but in other cases there appears to be no logical connection.

Id tell them not to be so hard on themselves. OR Delay time of starting to wash by one minute, delay time of starting to wash by two minutes, and so on. Also it needs to be someone who wont become upset if you cry or get angry. After two or three weeks I realised it was decreasing – I wanted to reduce it in the notebook and I didnt want to cheat, it had to be real. If you have a pet, sd quality time with it every day. They may be worried that you are about to faint (you may be worried about that too) but in fact you dont need any more breath, you already have too much. After that we tried it at night, outside in the rain, with the tape player the cameras, and my mobile phone. The problem with this is that pretty soon youve got a whole list of things that you cant do, life becomes a misery and you still suffer from Anxiety. Core beliefs that drive the vicious circle The internal logic that drives the vicious circle clearly isnt objective, but it can be very difficult to tease out the twists and turns of the belief. Qualities needed for self-help Anyone can apply the principles of self-help. Avoid cakes, biscuits, sweets and sugary drinks both at mealtimes and for snacks. I havent had a Valium since 198 Anxiety Disorders This is a brief overview so dont worry if your particular phobia or obsession isnt mentioned here. Start with the negative core belief, for instance Nobody likes me. Clearly in this example they are most worried about embarrassment. This is simply not the case. Food and drink Somebody who is well nourished will feel stronger and more able to face lifes challenges, and yet Anxiety often brings with it a lack of appetite, or a desire to eat comfort foods that may have little nutritional value. Before you undertake this kind of communication, sd some time thinking about what you are going to say. Most common symptoms, or the symptoms of the attacks would be dizziness, feeling faint, increased breathing, pounding heart, tingling or numbing sensations in the hands and feet, fear of impending doom, a disconnection with reality, or a total lack or loss of control. For many people, panic attacks are the foundation that their Anxiety disorder is built on. The great original affirmation is every day in every way I am growing better and better. It can feel pretty silly to look in the mirror and repeat this sort of thing, but all we can say is, it does work, so do it.

I do voluntary work and am going to build this up to full time, as preparation for getting a job eventually. Im a No Panic help line volunteer and mentor for other sufferers. How will you know when youve done enough work on your recovery?

Perhaps they feel unable to make eye contact, and lurk unhappily on the edge of the proceedings. The trouble is that the beliefs dig themselves in and hang on into adult life like bad habits that are hard to change. If youre not sure you could try the self-help methods that we suggest first and see if they help. It is also referred to as Social Phobia and can be a very traumatic and debilitating disorder making it near impossible for one afflicted with it to be comfortable at any social gathering. If youre not sure you could try the self-help methods that we suggest first and see if they help. Ill never find someone to love me. Finding counters for these kinds of thoughts is a question of persuading yourself to accept the evidence at face value, for example: Over-generalising Im always the one who struggles. Just think about the next step. What alternative explanation might there be for me having this thought? Cook your favourite meal. Do you worry about blushing or trembling when speaking to people? You would want to aid them, wouldn’t you? They dont need to understand the nature of Anxiety disorders, as long as they can accept that you need to do exposure in a certain way. Hold it and feel the tension in your forehead. Once you have found a belief that seems to be important, examine how you feel about it at the moment. Their overall function is to help you feel safe in a frightening situation. As usual its best to aim to do this gradually, in small manageable steps. Sit or stand, keeping your back straight. We are all likely to encounter events in our lives which produce anxiety. Put yourself in the picture behaving calmly and succeeding at the goal.

Inner directed or Other directed?

Am I looking at the whole picture? The best therapist in the world cant help you if you dont co-operate with them, and drugs will only dam the symptoms down to a level where you feel able to do the work thats needed. Healing your inner child The idea that each one of us has an inner child has been the butt of jokes in recent years, and yet its a concept that is useful in understanding ourselves. Now bend your arms at the elbows. If you can free yourself from the authority figures of your childhood, and free yourself from the need to please them, then you will acquire the freedom to be yourself. Has this been true in the past? Push down and out with your stomach, just above your navel and breathe in. On the other hand, if you take charge and work towards change that you choose, then you can make it hap in a positive way that leads you towards recovery. In addition, you can ask yourself other questions that will help you be more objective such as: Are there other ways of looking at this? Behaviour: avoid going out, even to the dustbin. Also, no one likes to waste food, and yet for someone who is struggling a whole banana or a whole slice of toast can seem just too much. At the onset of panic, breathe out into the bag, then breathe in from the bag. Visit corner shop when busy. You may find that one person has a soothing presence and you enjoy their company, while another is helpful in a practical way. Finish by pushing your stomach up a little to push out the last of the stale air. The flashes didnt frighten me as much as the noise. I must stay within my comfort zone to keep safe – I can create my own safe zone wherever I am. An assertive communication might be more like this: The result of this can be a permanent light-headed feeling, and fatigue. The person with OCD will feel anxious if they dont do their compulsions.

If your Anxiety causes you social difficulties then dont torture yourself by attempting this one – its meant to be a pleasure, not a pain.

Even when you succeed, you think it was a fluke, or a one-off. Changing your breathing There is an exception to most rules, and in the case of your nervous system the exception is breathing. Here is a brief overview: Physical: whether or not you suffer from panic attacks, the effects of Anxiety always have a physical element. The next step is to see what changes you can make to improve matters. The receptionist said to him isnt it kind of your sister to give you a lift? The woman was mortified, and cried bitter tears when she got home. Somebody drove into the back of my car once. Deep relaxation is an important part of recovery from Anxiety. Disappointment – if you havent come as far as you wanted. This builds up more Anxiety, making for another bad night, and so on. They vary from person to person but doctors use the following list – if you experience four or more of these sensations in the space of a few seconds then you are probably having a panic attack: shortness of breath a choking sensation rapid or irregular heartbeat chest pains tension in muscles trembling or shaking numbness intense sweating dizziness nausea urgent need to go to the toilet. Their overall function is to help you feel safe in a frightening situation. And it doesnt make your Anxiety go away. ought to take the approach that a setback is a sign that you are getting better and learn from it to move forwards again. Dont get thinking of that again. Something you could SEE the outcome from. Do you worry about blushing or trembling when speaking to people? Other type (such as situations that might lead to illness, choking, vomiting). Something unforeseen might hap that I cant cope with. There is a parallel effect on your mind. There is a huge range of volunteering opportunities, so you should be able to find something that interests you, and that fits in with any restrictions that Anxiety still imposes on you.

So if you havent seen your doctor yet, now is the time to do so.

This may be because you think you no longer need them, or you are experiencing unpleasant side-effects, or you are worried about becoming dedent on them. Hold it and feel the tension in the backs of your arms. Other medication: you may be asked to try beta-blockers or anti- depressants. You may need to make changes in your daily routine, or ask for extra patience and understanding while you work on your goals. I got three friends to come round with their cameras. In the lift example the person might set boundaries in this way: Remember, nothing is without risk of some kind. Its important not to let your friends and family become part of the problem. The first step is just to allocate a level of importance to the decision. Life will continue to present challenges. If these counts are too long for you, then choose your own numbers. Once you have stopped having caffeine you need to maintain that throughout your Anxiety recovery programme. ought to take the approach that a setback is a sign that you are getting better and learn from it to move forwards again. The aim is to reduce your dosage very slowly, in small steps, with plenty of time to adjust to each reduction. Work your way through your list of thoughts and devise an answer to each one. The answer is that behaviour does have to be changed, and starting with thoughts is too challenging for most people. It can make you feel excessively afraid in situations that are not stressful or threatening to most people. Understanding how Anxiety works. They will do this just by being there, and also there are things they can say to help: Grounding – remarks that remind you what to do such as just breathe out slowly. You may still feel that you havent really got time for yourself, but as a part of your recovery from Anxiety you need to find some time every day for yourself.

Changing your behaviours will help you halt the increase and prove to yourself that Anxiety does go down in the end whatever you do.

Will all of today be controlled by its power? Let your breathing be slow and calm again. Even though it turned out that you werent having a heart attack, the memory of that awful experience is still with you. We suggest that you ask them to talk to you calmly, to ask you if you feel you can go on just a little longer, and if you cant, then they accept that the goal will stop there. Examples of complex emotions are love, guilt, embarrassment and jealousy. Checklist – food and drink Its time to look at your eating and drinking habits and decide where you might benefit from making changes. Disadvantages of staying as I am I am isolated because of the time I sd checking. Mental distractions Counting – choose something to count – red cars, lampposts, people with hats on – to take your mind off the anxious feelings. I do feel anxious when I wake up though. When Im anxious I dont sleep at all, and if I do fall asleep I get terrible nightmares. I dont suffer from insomnia, when Im anxious I tend to sleep too much. I still get nightmares but I am getting better, not so scared of them. I use a computer programme that monitors heart rhythms and it shows you the importance of regular even breathing for coherence. Another approach is to set aside times for worrying: Worrying allowed on the hour, every hour, for ten minutes. If you are worried about lack of sleep, check to see that this really is the case – you may be surprised at how much sleep youre getting. Lets look at the situation objectively. If they are afraid of other people, they need to practise being with other people. If you persevere with the lifestyle changes and set yourself SMART goals, then youll make the risk as tiny as possible. Whole self: feel like giving up. This may be because you think you no longer need them, or you are experiencing unpleasant side-effects, or you are worried about becoming dedent on them. This is a vicious circle, because the less you use your body, the less you feel like using it. For some people the feared object is a symbol – it stands for their own feelings, and they are afraid of them. Changing your mindset is really important, but like everything else in your recovery programme, it can be done in small controlled steps.

Obsessive thoughts about harming someone or doing something immoral or taboo, may lead to compulsive thoughts about prayer to cancel out the obsessive thoughts.

He will tell you what you should do and the best steps for you to take to have fulfilling life with a dash of Anxiety on the side ;-). For instance someone who is housebound, and who contemplates their first trip outside, will set themselves an impossibly difficult challenge, often on the basis that anything less is hardly worth bothering with. Adults learn to let go of this mentality and accept themselves as they are. YES/NO If you are elated, excited or proud then just enjoy the moment. I get frustrated by the limitations imposed by my anxiety, but Im learning to accept them. It leaves behind fears, worries, and exhaustion. Unfortunately it wears off just as quickly, leaving you down in the dumps again. Your upbringing and early experiences may have caused you to believe that some emotions are not acceptable. This doesnt make any sense. If someone I knew had this thought, what would I say to them? But dont leave it till the end of the week and then try to remember everything, because you wont remember accurately enough. Without really thinking about it, you pick a dandelion flower and examine it. In fact as you move through recovery youre likely to feel complicated emotions, some of which may take you by surprise. This is a vicious circle, because the less you do the worse youll feel, physically, and the less youll feel able to trust that your body will see you through the panic. Once you have a record of your sleep over a period of time you can examine it to see if there is a pattern. Relax and feel the difference. Youll almost certainly have forgotten how bad things were, and how much progress you have made. If you have OCD, you may have already involved your friends and family, even if its just that they have to tolerate the extra time you need to do everyday tasks. Over-generalising usually includes words like never, always and every, so typical examples are: Ill never manage this goal. Im always the one who struggles. Filtering Filtering means selecting one aspect of an experience and focusing on that – and of course for an Anxiety sufferer this is going to mean filtering out the positive and focusing on the negative.