Life Health & Wellbeing

Tuesday 23 April 2019

Julia Molony: 'My tool-kit for anxiety - here's what I've learned'

Over the years I've tried numerous strategies to combat my anxiety, says Julia Molony. Here are six that helped me weather the storm to varying degrees

"Some strategies work better for me than others. However, you should consult your GP before trying any new treatment or medication. Here's what I've learned" Stock photo
Strategies can help you weather the anxiety storm

Over the many years that I have lived with an anxious mind, I've come to regard this disorder in meteorological terms. In my life, anxiety is as ineluctable as bad weather. Sometimes it's like drizzle. An uncomfortable inconvenience, certainly. A background bad buzz. But not likely to ruin my day. Other times, I feel more like the pilot of a light aircraft flying through a storm. The storm takes up all the space and the best I can manage is to cling on while the plane bucks, spins and shakes. During these phases I focus on the basics; working, taking care of my child, eating and sleeping. Everything else goes on hold until the sky clears. That can take a matter of hours. Sometimes it takes months.

Of course, it works the other way too. There are the endless stretches of blue skies that make me forget, for a while, that rain exists at all.

In the early days, when these phases of all-consuming worry were still new, I laboured under the illusion that I could be fixed. Perhaps if I changed my job, or moved to a different city, I'd be restored to the relatively carefree existence I'd enjoyed before? Maybe the right kind of medication could be the magic cure? Or the fretful part of my mind could be tamed by willpower alone?

Now, I realise it's not for nothing that experts talk about "management strategies" rather than remedies. I have an anxious nature and it is part of me, inextricably knitted into the fibre of my being. Even before I was fully aware of it, it was there, just dormant. Interventions are worthwhile, but it's instructive to view them as you would dressing for bad weather. You can't stop the storm from rolling in, but wearing your waterproofs might make it a bit easier to bear.

Here is a comprehensive list of some of the strategies I have tried to help weather the storm; hypnotherapy, cognitive behavioural therapy (CBT), Jungian therapy, anti-depressants, meditation, exercise. I've also tried a fair few of the ill-advised ones; alcohol, obsessive googling, taking to my bed. I learned the hard way why those approaches don't work.

There are the avant-garde and the borderline illegal ones I've toyed with, but not yet been driven to try; micro-dosing on LSD, converting to zen buddhism, expensive residential therapeutic programmes endorsed by celebrities. I like to keep them in the back of my mind in darker moments. Not because I'm likely to resort to them, but because it's comforting to know that not all avenues have been exhausted. When you are decompensating, you'd do anything to put the turmoil to rest.

Mood disorders run in my family; the poisoned root of our family tree, uniting the generations in psychic malaise of various shades. My grandfather, whom I never met, was a district psychiatrist in Ireland throughout the 1940s and 1950s. He also suffered from clinical depression. In those days, with pharmacological treatment options limited, he self-prescribed electro-convulsive therapy as a treatment, which he received in a clinic in Switzerland. This was before ECT was administered under anaesthetic. I'm told he found it extremely effective, though the results were temporary. Still, he willingly endured the agony of ECT for the sake of a reprieve from a tortured mind. ECT isn't recommended for anxiety disorders, so it's not one I can add to my list of last-ditch desperate measures. Still, I scour the health news pages regularly in hope for new treatments or medications that might one day be a sliver bullet. That can finally and definitively fix the cognitive glitch that regularly has me defaulting to panic at the slightest concern, or locked into days of rumination and dread, living out a worst-case scenario that hasn't yet come to pass. Until then, I turn to my bad-weather tool-kit.

Some strategies work better for me than others. However, you should consult your GP before trying any new treatment or medication. Here's what I've learned:

⬤ Mindfulness

Meditation, or mindfulness is widely touted as a panacea for everything from insomnia, to drinking problems to mood-disorders. A growing body of evidence supports this application as a self-care measure that might help us better manage the stresses of day-to-day life.

However, trying to practice mindfulness in the midst of an acute episode of anxiety is, to my mind, a waste of time. When in full fight-or-flight mode, my sympathetic nervous system going haywire and my mind running doomsday scenarios on repeat, taking a moment to focus on my breath can be useful but anything more than that - and certainly trying to sit down for a sustained period of stillness, is impossible. It sounds paradoxical, but in order to meditate properly, you have to be calm enough at the outset.

⬤ Hypnotherapy

If smokers can magically be transformed into non-smokers, perhaps I could I be magically transformed from a worrier into a non-worrier, by way of the suggestibility of my unconscious mind? In desperate hope, I forked out a considerable amount for a course of sessions with a hypnotherapist. It was pleasant, and quite relaxing, but sadly, the lightening-bolt conversion I'd hoped for wasn't to be.

⬤ Jungian therapy

There's most likely a genetic component to my anxiety, but I believe it's likely that "nurture" plays a big part too. Certain circumstances of my early life may have contributed. Which is why I spent close to a year undergoing weekly sessions with a Jungian psychotherapist.

We analysed my dreams, and my close relationships. I learned a few interesting things about managing family dynamics, and definitely enjoyed and benefited from the emotional support of having a professional with whom to talk over my problems. I believe the process may have helped me accept my fate as an anxious person. It did not, however, reduce its impact on my life.

⬤ Medication

When things get particularly dicey, I visit my GP for a prescription of Citalopram or Sertraline. These drugs are SSRI's (selective serotonin re-uptake inhibitors) a type of antidepressant which are also widely used as a treatment for anxiety disorder.

The drugs work by increasing the availability of the neurotransmitter serotonin to the synapses in the brain. I held off for a long time before agreeing to take them the first time around. Mostly because, needless to say, I was in a panic about it. I agonised about possible side effects. I fretted about risks of addiction. I believed that resorting to medication in order to cope was a monumental admission of failure.

With hindsight, I wish I hadn't wasted the time. I now know that these medications can be a swift and indispensable crutch when things get just too hard. I've been on them three or four times over almost a decade and have successfully weaned myself off them without issue each time. It can take about two weeks to feel the benefits, though I usually notice a difference within days.

My late-aunt, also a psychiatrist, used to advise that sometimes just knowing you have the prescription in your handbag can make the difference between coping and not coping. I've found that to be true.

⬤ Exercise

Physical activity, as we all know by now, is not just a good thing for anxious people to do, it is the sine qua non of good physical and mental health.

The theory, where anxiety is concerned is that it provides an essential release valve, a way to discharge all the excess adrenaline which surges through the bloodstream when some new fear tips you into flight or flight. I'm not a naturally athletic person, so getting out for a swim or a run can be a struggle. But I've never pushed myself to do it and not felt considerably better afterwards.

⬤ Cognitive behavioural therapy

As talking-cures for anxiety go, CBT is considered the "gold-standard". It is widely considered to be at least as effective as antidepressants.

In CBT the therapeutic approach is not to excavate the life-experiences that have contributed to anxiety (you won't spend long hours analysing your relationship with your mother, though it might be acknowledged as a contributing factor). Rather it focuses on pragmatic approach to addressing unhelpful belief systems and deconstructing negative thought patterns. Once these have been identified, they are broken down into manageable parts and addressed individuality, with strategies to stop them in their tracks.

Distraction is a key principle, breaking a thought pattern by switching your brain to something else before you get stuck in a loop.

I underwent a course of intensive CBT in 2014. It didn't cure my anxiety. But some aspects of it were a revelation. It taught me to recognise when my thought patterns become dysfunctional. It helps me get little bit of critical distance, which can be vital in the midst of panic. For those times when I am utterly convinced that disaster is upon me and all is lost, CBT taught me the value of doubt.

Now I allow space for the possibility that the worst-case-scenario might not be true. It might just be a trick of my troubled mind.

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