Tuesday 16 October 2018

10 steps to help manage your anxiety

Dr Claire Hayes outlines her ten steps to manage the condition

Some people cope better with anxiety than others
Some people cope better with anxiety than others
You can take steps to control your anxiety
There is a difference between experiencing anxiety and being anxious
Supporting someone who experiences anxiety may not be easy
Confronting our worst fears can be helpful
Death is inevitable
Dr Claire Hayes. Photo: Damian Eager

We had the Stone Age, the Iron Age, the Bronze Age, the Industrial Age, and the Technological Age. Now we have the Age of Anxiety. Why do I say that? We are bombarded with messages from the world about all the things that are dangerous, could be dangerous, or will be dangerous.

These include people such as terrorists, paedophiles and even some politicians. They include imminent natural disasters such as flooding or fire and food substances such as sugar. Our body's natural response to real and/or perceived stress has been called the 'fight or flight' mechanism.

While our ancestors used this to literally fight bears or run away from them, we use it as an automatic response to requests from colleagues, friends or family members. Our heart rate can speed up, our hands can feel clammy, and our stomach may feel nauseous.

Few of us actually fight and few of us flee. Many of us freeze. We too often beat ourselves up for experiencing anxiety in the first place, considering it to be a weakness, rather than a normal reaction to the multiple stressors that surround us. We also underestimate the power of our own thoughts to trigger our fight or flight response. It is easy to test this: right now imagine the following:

Dr Claire Hayes. Photo: Damian Eager
Dr Claire Hayes. Photo: Damian Eager

1. You are at a sports match cheering as your team wins the final.

2. You have been queuing for 10 minutes in a supermarket when the aisle is suddenly closed and you are asked to move to a different aisle.

3. You arrive home and you see an ambulance with flashing lights parked directly outside.

Did you notice any changes in yourself as you read the three different scenarios? We know that our thoughts can trigger us to feel emotions such as upset, pleasure, relief and anxiety. This is a normal phenomenon, but if we are constantly bombarded with external stressors and the impact of our own thoughts, we are likely to experience anxiety at a level that is not good for us.

People of all ages experience anxiety. In my experience, these are often people who are very intelligent, do not like to get into trouble, do not like to make mistakes, do not like to let people down, and who tend to look to other people or other things to make them feel better. This is understandable.

Think of yourself in your car, just about to leave home and you suddenly think 'Did I lock the front door?' If you are like me you may notice a stab of anxiety and automatically get out to check. Checking can bring immediate relief. Yes, the door is locked. Many of us only check once and are able to drive away satisfied.

There are many others who sit back into their car and question if they actually checked properly to make sure that they had locked the door. They will likely feel anxious again and in an attempt to feel better, they will go back and check again. The immediate feeling of relief they get does not seem to be something harmful.

Why would any of us not do something to make us feel better? Paradoxically, checking to feel better can too easily lead us to fall into the 'checking trap'. The more we check, the more we need to check. People who know that they have obsessive compulsive disorder (OCD) will recognise this pattern. Those of you who do not may struggle to understand why on earth someone would spend literally hours caught in a trap of checking to see if doors are locked, hands are washed, or even that people are not offended by something they did or did not do.

It is tempting to reassure saying that 'of course the door is locked', not realising that such reassurance does not work. Someone who is experiencing anxiety may well minimise whatever reassurance they get. This is particularly obvious for people who are anxious about their health. How can anyone say that a cold is in fact only a cold or a lump is only a cyst? We all know people who had colds that turned out to be pneumonia and people who had lumps that turned out to be cancer.

I have been interested in helping people understand and cope with anxiety for over 30 years now. The 'Coping Triangle' is the three-step approach I have developed to explain the key principles of cognitive behavioural therapy in a practical way.

The more I work with people who experience anxiety, the more I recognise the extent to which I was anxious at times when I was a child, a teenager and a young woman. I still experience anxiety. I see it now as part of how I am and thankfully I am much better at recognising it and managing it.

The following 10 points are ideas I have about anxiety that I have shared with many others who have successfully learned to understand and manage their anxiety too. I present these here in the hope that you will find them beneficial also.

There is a difference between experiencing anxiety and being anxious

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There is a difference between experiencing anxiety and being anxious

Every person alive today experiences anxiety. This is normal and important. Not all of us become defined by this anxiety. Some people do. They describe themselves as 'anxious' and other people quickly see them as anxious. It does not take too long before 'being anxious' becomes a core part of them. When this happens, it can be difficult to see who they are separate from their anxiety.

Reassurance does not work

The truth is that none of us can actually say with absolute certainty that the things we fear will not happen. We may do our very best to ensure that nothing bad ever happens, but we cannot guarantee that our efforts will work.

Death is inevitable

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Death is inevitable

When I gently probe what is driving someone's anxiety, more often than not, anxieties about death emerge lurking very close to the surface. Children worry that their parents might die or that they themselves might die. Parents worry that they might die or that their children might die. We are all going to die, but this tends to be something that we prefer not to consider until we have to.

Breaking out of the Checking Trap can cause anxiety to increase

It may not be easy for any of us to take our power back from anxiety. Facing our fears can actually increase our levels of adrenaline. I see this as being similar to chemotherapy being a recognised treatment for cancer, even though it can make people feel sick.

Confronting our worst fears can be helpful

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Confronting our worst fears can be helpful

This can be helpful although it may be far from easy. Often when I ask people to consider what they would do if they knew they had five days left to live, they look at me in horror. Many tell me that they would spend all of that time crying and would not be able to cope. When we explore this a little more, they realise that while they might feel upset, afraid or angry, they would use the time left to them creating very special memories for the people who will be left behind. They might also use this time to complete tasks they had put off and/or to do something they had always wanted to do, but had put on the 'long finger'.

It can be easy to minimise any success in facing anxiety

Sometimes when people discover that they can take their power back from whatever was causing them to be anxious by facing their fear, they minimise their successes while continuing to focus on something that they 'know' they will never be able to do. This seems strange, but in my experience, it is very true. I have so often been delighted with the progress that someone has made, only to discover that they have completely disregarded any of their achievements.

People who experience anxiety can be very controlling, determined, and can dig in their heels

This is intended as an observation rather than a judgement. It is understandable that any of us would prefer not to feel anxious. It can make us feel really ill. Some people actually become physically sick. They may think that they are going to faint and even worry that they might die. Once they discover that they feel better immediately by not doing whatever it is that they dread, they can dig in their heels and resist any and all attempts to get them to do whatever it is that triggers them to feel anxious.

Supporting someone who experiences anxiety may not be easy

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Supporting someone who experiences anxiety may not be easy

Think of a young child who is upset. Instinctively we pick her up, cuddle her, and protect her from whatever it was that caused her distress in the first place. It seems almost unthinkable that anyone could ever suggest that we ignore the fact that she is upset. We feel better when we comfort the child and our reward comes when we see her smile and relaxed. We feel good when she feels good. We feel anxious when she feels anxious, and we feel bad when she feels bad.

Where there is a child who experiences anxiety, there often is an adult who does too

It makes sense that one or both parents will experience anxiety if they know that their child is feeling anxious. It can be a 'chicken and egg' dilemma. Which comes first, the child's anxiety or the adult's? It makes sense that parents are going to feel anxious if their children are in danger, or if parents think that they are in danger. Protecting their children can make them feel better, but that is not necessarily always helpful. All too quickly, the child can learn that they are not able to face difficult things and can see themselves as needing protection.

Some people cope better with anxiety than others

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Some people cope better with anxiety than others

How we cope with anxiety depends on a range of factors, including our personality, our past experiences of anxiety, and how we coped with them, how we witnessed our parents, teachers and key adults cope when we were younger, and the frequency and intensity of anxiety triggers that we have experienced as adults. Finally, we can all find hope in the truth that we can all learn to understand and cope with anxiety.

* 'Finding Hope in the Age of Anxiety' By Dr Claire Hayes is released on Friday, March 3, by Gill Books, €14.99

6 ways to cope with anxiety

You can take steps to control your anxiety

1 Know what triggers you to become anxious. These may be external things such as dogs, exams or lifts. They may also be thoughts of things you consider frightening such as dogs, exams or lifts!

2 Recognise and acknowledge your physical symptoms as anxiety. These might include your heart racing, speaking quickly, or needing to use the bathroom frequently.

3 Resist the natural tendency we all have to avoid whatever is causing us discomfort, unless it is something that genuinely is going to harm us.

4 Practice relaxation and breathing exercises on a regular basis, not just when we feel anxious.

5 Deliberately face whatever is causing us to feel anxious realising that this may actually make us feel more anxious.

6 Recognise and appreciate every single time we take our power back from anxiety rather than immediately minimising our efforts and blaming ourselves for having experienced it in the first place.

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