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'I stopped giving dinner parties because I just couldn't bear the anxiety about getting everything ready in time. It sometimes got so bad that I'd start worrying days before the event.' 'I can never look
forward to a holiday in the sun as it involves flying. It just doesn't
suit me. I get clammy hands, my heart races, I feel claustrophobic, and
sometimes I just panic and want to escape.' Anxiety is something we all experience from time to time. Most people can relate to feeling tense, uncertain and perhaps fearful at the thought of sitting an exam, going into hospital, attending an interview or starting a new job. You may worry about feeling uncomfortable, appearing foolish or how successful you will be. In turn, these worries can affect your sleep, appetite and ability to concentrate. If everything goes well, the anxiety will go away. Short-term anxiety can be useful. Feeling nervous before an exam can make you feel more alert and enhance your performance. However, if the feelings of anxiety overwhelm you, your ability to concentrate and do well may suffer. Anxiety and fear are actually important for survival because they act as a mechanism to protect the body against stress or danger. Anxiety and fear trigger the release of hormones such as adrenalin. Adrenalin causes your heart to beat faster in order to carry blood to where it is most needed. You breathe faster to provide extra oxygen, which is needed for energy. You sweat to prevent overheating. Your mouth may feel dry as your digestive system slows down to allow more blood to be deflected to your muscles. Your senses become heightened and your brain becomes more alert. These changes enable the body to take action and protect itself in a dangerous situation, either by running away or fighting a foe. It is known as the fight or flight reaction. Once the danger has passed, other hormones are released which may cause you to shake as your muscles start to relax. This response is useful for protecting against physical dangers. However, our bodies react in the same way to situations we may find threatening but cannot deal with appropriately by fighting or running away, such as public speaking, a driving test, or having a blood test. What causes anxiety? Anxiety can be triggered by a number of factors. Something distressing may have happened to you in the past and because you were unable to deal with the emotions at the time, you may become anxious about encountering the situation again, just in case it stirs up the same feelings of distress. You may worry about the future. Sometimes, if we feel we are not in control of different aspects of our lives, we can start to feel anxious about the future and any possible events that could be beyond our control, such as nuclear war, fear of being attacked, of developing cancer, or of losing a job. Feeling anxious can also be a learnt response something picked up early on. Your family may have tended to see the world as a hostile and fearful place, for example. Caffeine, excess sugar, poor diet, drug misuse, exhaustion, stress and the side effects of certain medication can also cause anxiety. After a while, you can start to fear experiencing the symptoms of anxiety, especially feeling out of control. This sets up a vicious circle: you feel anxious because you dread feeling the symptoms of anxiety and then you experience those symptoms because you are having anxious thoughts. What are the effects of anxiety? Anxiety affects body and mind. Increased muscular tension can cause discomfort and headaches. Rapid breathing may make you feel light-headed and shaky, and give you pins and needles. Rising blood pressure can make you more aware of a pounding heart. Changes to the blood supply affecting the digestive system may also cause nausea and sickness. The effects on your nervous system may manifest themselves in an urgent need to visit the toilet and butterfly feelings in the stomach. Sometimes anxiety can take the form of a panic attack: the rapid build-up of overwhelming sensations, such as a pounding heart, feeling faint, sweating, nausea, chest pains, breathing discomfort, feelings of losing control, shaky limbs and legs feeling like jelly. You may fear you are going mad, will black out, or are having a heart attack. For further information see Mind's booklet, How to Cope with Panic Attacks. The psychological effects of anxiety include fear, heightened alertness, feeling on edge, irritable, unable to relax or concentrate. You may feel an overwhelming desire to seek the reassurance of others, be weepy and dependent. The way you think can be affected: you may fear that the worst is going to happen and slot everything that occurs into a pessimistic outlook on life. For example, if a friend is late, you worry that they have had an accident or don't want to see you, when in fact their train was delayed. Increased alcohol consumption, smoking, phobias and obsessive actions may also be expressions of anxiety. You may try to avoid certain situations and maintain relationships that either support your anxious outlook or help you to avoid situations you find distressing. Long-term anxiety can affect your health. Your immune system can become less effective, thus making it more difficult to fight off infection. Increased blood pressure can cause heart, kidney and stroke problems. You may experience digestive difficulties along with other health problems, including depression. You may find it difficult to hold down a job, develop and maintain good relationships, or simply enjoy leisure time. Sleep problems may further aggravate anxious feelings and reduce your ability to cope. For further information see Mind's booklet, How to Cope with Sleep Problems. How can I manage anxiety? There are many things you can do to reduce your anxiety to a manageable level. Taking action may make you feel more anxious at first, even thinking about anxiety can make it worse. But facing up to anxiety and how it makes you feel can be the first step in breaking the cycle of fear and insecurity. It is important to remember how much better you will feel when you begin to relax, take control and are able to lead a fuller life. Controlling the physical symptoms of anxiety These symptoms of anxiety can be controlled by breathing techniques, relaxing muscles and by replacing distressing and negative thoughts with positive and peaceful ones. These methods are straightforward and can be learnt from books, video and audio tapes, through cognitive counselling, and attending relaxation classes. Classes in yoga or meditation can also be quite helpful. Drugs Tranquilizers and sleeping pills are frequently prescribed by doctors to people who suffer from anxiety. They may offer some relief, but they can make you feel sluggish, unable to concentrate and that you don't care about anything. They don't help you deal with the problems that are making you anxious. You can become addicted to them, so coming off them may cause withdrawal symptoms. These can seem worse than the original feelings of anxiety. Increasingly, doctors are reluctant to prescribe tranquilizers for more than a few weeks. Long-term tranquilizer use has been linked with the occurrence of panic attacks. Sometimes antidepressants or other drugs may be prescribed. They may relieve symptoms, but again don't deal with the causes of anxiety and can include anxiety and insomnia amongst their possible adverse effects. Complementary therapy Complementary therapies can help you to relax, sleep better, and deal with the symptoms of anxiety. The most common of the complementary therapies are aromatherapy, massage, reflexology, herbalism, Bach flower remedies, homoeopathy, and hypnotherapy. Many chemists and health shops stock different remedies and may be able to offer information. For further details, including a list of therapists, contact the Institute for Complementary Medicine. Mind's booklet, the A-Z of Complementary and Alternative Therapies may also prove helpful. Exercise Taking more exercise can help you cope with anxiety and feelings of tension. And you might get a better night's sleep thrown in as a bonus. Exercise uses up the adrenalin and other hormones which are produced under stress, allowing muscles to relax. Also, certain brain chemicals are released during exercise which can enhance your mood. Walking and swimming allow you to be active at your own pace and you can do them alone or in company. If you feel embarrassed exercising in front of others, do it indoors: dance, stretch or move along to a tape. Counselling therapies There are different types of counselling available. Some help with how you are feeling, others look into reasons why you may be experiencing anxiety. Cognitive therapy encourages you to develop positive ways of thinking and to construct strategies for managing anxiety so you feel in control. For further information, see Mind's Factsheets, Psychotherapy Counselling, Cognitive Therapy, and Hypnotherapy, and Mind's booklet, Getting the Best from your Counsellor or Psychotherapist. Assertiveness Learning how to handle difficult situations and standing up for ourselves can make us feel more confident and thereby relaxed. For some people, learning self-defence may make them feel more safe. See also Mind's booklet How to Assert Yourself. How can friends and family help? Anxiety is something most of us can relate to. For some people, anxiety can be disabling and interfere with their ability to lead full and satisfying lives. Recognizing how you feel during times of anxiety can help you empathize with a friend or relative who is going through a bad patch. People with severe anxiety can often feel bad about themselves and may need reminding that they are not a bad person and have many good points. Being supportive is finding a balance between accepting the person and not pushing them into situations which are beyond them, yet at the same time not being too protective and assisting them to overcome small challenges. In this way they can develop their self-confidence and feel in control. Sometimes a bargain can be struck: if the friend agrees to go to relaxation classes then you will travel with them and meet them afterwards. If someone is distressed, they may need to be reassured that it is OK to cry. Letting out feelings can relieve tension. Laughter is relaxing; helping your friend to have a good laugh may be one of the most useful things you can do for them. They may also need support in finding appropriate channels to express anger, even if this is just bashing a few cushions about. Some people may be embarrassed at not feeling in control. They may blush or shake, and need reassurance that it is not as obvious to other people as it is to them. Sometimes, physical closeness such as a reassuring touch, hug or even massage can be soothing. Supporting someone else through emotional problems can be very rewarding, but it can also be very frustrating. Look after yourself, or else you are likely to become impatient with them, and tense and irritable yourself. Finding someone you can confide in might be very useful. If you are living with the person, make sure that you have a break. If their anxiety is stopping them doing things, that does not mean you should stop as well. You should not feel guilty doing things on your own. If you enjoy your life you will find it easier to be loving and supportive. If, on the other hand, your friend feels you are being a martyr, they will feel bad for spoiling your life. Useful organizations For local resources try your GP local Mind association, community health council, library, or adult education institute. British Association for Behavioural and Cognitive Therapy P0 Box 9, Accrington, Lancs BB5 2GD. Nationwide list of cognitive counsellors. Send an SAE for details of those in your area.
British Association for Counselling 1 Regent Place, Rugby, Warwickshire CV21 2PJ. Nationwide list of counsellors and psychotherapists. Send an AS SAE for details of those in your area.
First Steps to Freedom 1 Castle Court, Park Road, Kenilworth, Warwickshire CV8 2GF helpline 01926851608. Offers advice, information and support.
Institute for Complementary Medicine P0 Box 194, London 5E16 1QZ, tel. 0171 237 5165. Send an SAE for a list of individual practitioners.
No Panic 93 Brands Farm Way, Randlay, Telford, Shropshire TF3 2JQ, helpline 01952 590545 lOam-lOpm. Offers advice, information and support.
Stress Management Training Institute Foxhills, 30 Victoria Avenue, Shanklin, Isle of Wight P037 6L5, tel. 01983868166. Produces leaflets and cassette tapes which help you to relax. Has a list of people who teach relaxation classes. |
