Free Yourself from Anxiety (24 page)

How will you know when you’ve done enough work on your recovery? It depends what you’re aiming for, but feeling comfortable in your own skin is a good place to be. It’s so easy for children to develop low
self-esteem
, and to feel that they don’t measure up, because they are being assessed all the time, at home, at school and even in their leisure activities. Adults learn to let go of this mentality and accept themselves as they are.

If you continue with your healthy lifestyle, and your positive thinking, continue to be more assertive in dealing with other people and continue to release feelings instead of bottling them up, then you will change in ways that you would not have thought possible. The changes in your everyday life will be permanent and at a deep level – things will happen, but you’ll take them in your stride instead of using them as yet another chance to judge yourself.

Working on your self-esteem can be a long and painful process but it is essential as part of learning to be okay with who you are. You may have to contend with some deep-rooted beliefs about not being of value, or of not deserving a good life, or of needing to conform.

Remember that adults don’t need to prove themselves by their achievements. Life is not a test which we pass or fail. 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. You will no longer fear other people’s disapproval.

You also don’t need to feel guilty about the journey you are on. Of course it’s true that many people alive today do not have the luxury of worrying about their self-esteem, or their core beliefs, because they are entirely focused on survival – enough to eat, a future for their children.

But don’t say to yourself ‘I’m feeble because I’m struggling with issues that so many people can never have the chance to think about’. You are not feeble, although you may be lucky that your basic needs are taken care of.

It seems to be the case with all human beings that once we have managed those basic human needs (food, water, air, sleep) we then turn our attention to other matters. Even the most primitive of human cultures have a spiritual aspect, and allow their priests or shamans to live without working the land or hunting. All you are doing is moving away from the basic survival needs to the deeper needs that we all have.

As you let go of Anxiety and learn to relish your new life you will probably become aware that you have unused potential. You may decide to explore your creativity, learn a new skill or widen your social network. When you open yourself to life, new opportunities seem to arise almost magically.

If you feel you’ve done as much as you can through self-help, and want to make still more progress, then you can look elsewhere for help and support. Sometimes all that is needed is a little input from someone who understands, and there are charities that offer mentoring schemes for people with Anxiety disorders. Or you may decide to speak to a counsellor or psychotherapist – this is especially useful if you have identified difficulties in your past that you need to address.

There are many types of counselling and psychotherapy. Some types are more suited to short-term work, with a fixed number of sessions. In fact
cognitive behavioural therapy is typically delivered in between six and 15 sessions.

If you need to explore issues of self-development or personal growth, or to overcome the effects of childhood deprivation or abuse, you are likely to need a longer and more open-ended approach.

The main types of open-ended help are:

Some practitioners describe themselves as ‘integrative’. This means their training has covered more than one approach, and they can choose between the different styles to suit each individual client. Sometimes you will see the word ‘holistic’ applied to therapy. A holistic practitioner claims to treat the whole person, to look at the cause of their illness as well as the symptoms, and to examine all aspects of the problem (mental, physical, spiritual and emotional).

Do choose someone who is registered with the United Kingdom Register of Counsellors (UKRC). This means that the counsellor must be appropriately trained and qualified, work to a Code of Ethics & Practice and be subject to a complaints procedure. To get details of registered counsellors in your area, contact the British Association for Counselling and Psychotherapy.

It’s time to say goodbye to Andrea, Andrew, Bridget, Julie, Margaret, Norman, Pen, Sarah, Teresa and Wendy. By reading their stories we hope you can see that Anxiety is an illness that strikes ordinary people. If you have an Anxiety disorder you are not odd or strange, and above all you are not alone. You are part of a large group of people, none of whom chose to join the group.

You can also see from their stories that recovery is possible and that life can feel good again. All of them have travelled from mental anguish to a position where, at the very least, they feel optimistic about the future. Some of them are already fully recovered, and some of them are able to help others by working as volunteers with one of the charities in the field. Their generosity in telling their stories, and reliving some of their pain, shows how much they want to help.

This simple relaxation exercise teaches you to tense each set of muscles in turn and then relax it. As you work your way around your body you will gradually become more relaxed.

You can use this script by reading to yourself or by recording it and playing it back. You can also ask someone else to read it to you or record it. Be sure to read it slowly, in a calm voice, and pause for several seconds at the end of each section.

Very few people become fully relaxed the first time they try – it often takes many repetitions, and each time you work through a relaxation session you will gain a little more benefit – it builds up slowly. Occasionally the first session has the opposite effect, and it sends you into a deep sleep. Don’t be concerned if this happens to you, it’s only a sign that anxiety was making you very tired.

Remember to relax in a place that is warm, safe and comfortable. Arrange things so that you won’t be disturbed for the half hour or so that it takes. Sit comfortably or lie down to do your relaxation. Where the script says ‘hold it’, you should maintain the tension in that muscle for a few seconds.

Focus on the word relax. Breathe in and out through your nose and let your breathing slow down. Each time you breathe out, let yourself relax a little more. Close your eyes, and focus on the word relax.

Clench your fists. Feel the tension in your fists. Hold it. Relax your fists and let yourself feel the difference as your hands relax. Breathe quietly, and focus on the word relax.

Now bend your arms at the elbows. Try to bring your wrists right up to your shoulders. Hold it and feel the tension in your upper arms. Relax your arms and let them fall back comfortably. Let yourself feel the difference as your arms relax. Keep focusing on the word relax.

Straighten your arms as hard as you can. Hold it and feel the tension in the backs of your arms. Relax your arms and notice the difference in your muscles.

Shrug your shoulders, bringing them up towards your ears. Hold it. Feel the tension in your shoulders. Relax and feel the difference.

Press your head back, hard. Harder. Hold it and feel the tension in your neck. Really feel it. Now relax and feel the difference.

Raise your eyebrows and wrinkle up your forehead. Hold it and feel the tension in your forehead. Now relax your eyebrows and forehead. Keep breathing slowly and calmly.

Now frown and squeeze your eyelids tightly shut. Feel the tension in your eyelids as you hold it. Relax and feel the difference.

Clench your teeth as tightly as you can. Really feel your jaw muscles tighten up. Hold it, then relax and feel the difference. Focus on the word relax.

Next, push your tongue up against the roof of your mouth. Hold it and feel the tension inside your mouth and throat. Relax your tongue and feel the difference.

Press your lips tightly together. Hold it and really squeeze your lips together. Relax and feel the difference.

Tense your chest muscles by taking a deep breath. Hold it, then relax by breathing out. Feel the difference as your chest muscles relax. Let your breathing be slow and calm again.

Now clench your stomach muscles tightly. Hold it and clench your stomach muscles as tightly as you can. Relax, and feel the difference.

Arch your back slightly and clench your buttocks. Hold it and feel the tension in your back and buttocks. Relax, and feel the difference. Focus on the word relax, and breathe gently and calmly.

Straighten your legs, and point your toes downwards. Hold it and feel the tension in your legs and feet. Relax, and feel the difference. Keep focusing on the word relax.

Let the feelings of relaxation spread throughout your body. Feel every muscle return to a position of relaxation. Allow yourself to enjoy the peaceful calm feeling of relaxation. Stay quietly relaxed for a few more minutes. When you are ready, stand up slowly.

Your lungs are inside your ribcage, and there is a whole network of muscles that help you with the movements that will expand and contract your lungs. Healthy breathing uses all of these muscles.

Imagine your lungs have three sections – top, middle and bottom. Unhealthy breathing, as you already know, only uses the top section. Here’s how to feel each of the three sections:

Take your time with this exercise. Only do as much as you feel able to do – if you have been breathing badly for years, you might find it quite strange to breathe correctly. The final stage, where you push your stomach out as you breathe in, is actually using your diaphragm, a strong muscle that sits underneath your lungs.

Once you’re comfortable with the three sections, you can learn how to breathe smoothly through all of them.

As you can see, this is quite complicated and takes a while to master. Practise it every day, say for two sessions of 15 minutes each. Because it is complicated you will find that you are breathing much more slowly, and that is a good thing. Aim to breathe in and out about eight times a minute – you might find this difficult at first, but persevere.

There is a strong connection between breathing and your emotional state.

Excitement can make you feel breathless, distress can make you sob, emotional pain can make you hold your breath and so on. It’s a two-way street, and changing your breathing can bring about a change in your emotions.

Here are some alternative ways of working with your breathing and calming yourself, taken from Yoga.

This breathing exercise is calming, and also some people find it helps them to fall asleep. It also exercises your diaphragm and makes it stronger.

The sniffing breath is a way of freeing up a tight chest.

This helps with diaphragm control and relaxation. You will need a lighted candle – be careful with it.

If you have been prescribed drugs for Anxiety, especially if you have been taking them for some time, you may wish to give them 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 dependent on them.

On the other hand, you may be worried about what will happen if you do give them up – will you have nasty withdrawal symptoms; what if your Anxiety resurfaces once the medication is taken away?

Problems with medication have focused mainly on the group of tranquillisers known as benzodiazepines: diazepam (Valium), chlordiazepoxide (Librium), lorazepam (Ativan) and alprazolam (Xanax), as well as those used to help with sleep: temazepam, nitrazepam and
flunitrazepam (Rohypnol). The main problems are that tolerance develops (which means that you need higher doses to achieve the same effect) and withdrawal symptoms occur if you try to come off these drugs too quickly.

More recently there has also been a lot of talk about whether
anti-depressants
, and particularly some of the newer classes of
anti-depressants
like Seroxat and Prozak, can cause similar problems.

The decision whether or not to continue taking the drugs is not always an easy one. You need to weigh up whether they are helping against the disadvantages.

Benzodiazepines can cause a range of side effects, the most common being confusion, stumbling, memory loss, drowsiness, light-headedness, a hangover effect (feeling the effects of the drug the next day), and an increase in aggression. They can impair your ability to drive or operate machinery, and can also be dangerous if mixed with alcohol. This can place restrictions on your ability to work, your freedom of movement and can interfere with enjoyment of social activities or pastimes which require mental alertness.

Current advice to doctors is to only prescribe these drugs for short periods (two to four weeks) and only for severe Anxiety. However, people who were prescribed these drugs before the dangers were fully recognised are still taking them because they are afraid to stop. It’s important to come off these drugs slowly. Don’t ever just stop taking them. This can cause unpleasant, and possibly dangerous, physical symptoms including convulsions.

The first step is to talk things over with your doctor. If on balance you feel you would be better off without the drugs, then ask him or her about helping you to withdraw from them. If your doctor is not experienced in tranquilliser withdrawal, then ask for a referral to someone who is.

The aim is to reduce your dosage very slowly, in small steps, with plenty of time to adjust to each reduction. This will reduce the risk of severe withdrawal symptoms and you will gradually start to feel more alert and energetic.

Many of the symptoms of withdrawal are similar to those of Anxiety and it may be difficult to tell whether what you are experiencing is temporary or whether the underlying Anxiety is resurfacing. Psychological support, either through self-help groups or from a professional therapist, can be helpful at this time to help you understand what is going on and also to learn new ways of coping without going back to the drugs.

These are likely to include fears of some or all of the following:

Agoraphobia and claustrophobia may begin with a single incident of panic but become more generalised because of fear of losing control or fainting in any public situation from which it is difficult to escape.

You will need to set separate goals for each category, and construct an exposure ladder of steps towards each goal.

There are many specific phobias, which can be put into groups. The authority most widely used by psychiatrists and other professionals worldwide is the Diagnostic and Statistical Manual 4
^th
Edition 1994 (or DSM-IV) published in the United States and available online. This gives the following categories for the most common specific phobias:

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 Appendix 2).

Remember, whatever it is called, and whatever the circumstances which trigger it, the root is always Anxiety, and the way to recovery is similar.

Some phobias might belong in one category or another, depending on what the actual trigger is, or be part of a more complex condition such as agoraphobia.

This is a complex condition, covering a range of fears to do with behaving or performing in front of other people. If you have social phobia you will worry about people looking at you and noticing what you are doing. You fear that you will do something which will be embarrassing or humiliating, or that people will be critical of you or reject you. You may be very self-conscious about your appearance or body size/shape, or have doubts about your ability to do or say the right thing.