Free Yourself from Anxiety (9 page)

Making changes to your lifestyle is only the beginning of your recovery from Anxiety – for some people there will be a huge impact on their Anxiety, although for others there will be very little difference. The only way to find out is to try – and in any case you will benefit from having a healthier lifestyle.

In this section we are going to move on to the next stage of constructing your recovery programme. Keep working on the lifestyle changes as you read through the next few chapters. Start by answering these questions.

Look at the questions you answered with a yes. These will help you understand the nature of your Anxiety.

Yes to questions 1 and/or 2 are signs of Generalised Anxiety.
Yes to any of questions 3–7 indicates different types of phobia.
Yes to question 8 refers to OCD.

It is possible to have a combination of these. If your specific difficulty isn’t mentioned, don’t worry. The techniques we describe will still work for you.

We’ve already said that Anxiety affects every aspect of your being. Here is a brief overview:

Now examine each aspect of your life and decide how Anxiety affects it – use your notebook and work through each of the headings on the previous page. Here is an example from someone with severe agoraphobia:

Understanding the detail of your particular Anxiety problem will help you focus on the changes you can make. As you change some things, you’ll find that others change without you making a conscious effort. The lifestyle changes in section one were aimed at reducing some of the physical effects of Anxiety. This section will concentrate on your behaviour – the things that you do because of your Anxiety.

There’s no doubt that Anxiety does affect behaviour, although the details will be different for each person. Here are some of the most common Anxiety behaviours.

The urge to get out, get away, escape from the situation where the Anxiety or panic strikes can be overwhelming. It’s part of the fight-
or-flight
mechanism which fills you full of physical energy and makes you want to
do
something. When you do leave, you find that you start to feel better quite quickly, so you’ll tend to think that escaping makes Anxiety go away. Next time you’ll feel even more keen to escape, and soon a pattern is established.

It’s important to understand that escaping does not make Anxiety go away. The adrenalin surge of fight-or-flight always dies down, even if you stay put.

This usually follows on from escape. If getting out of a certain situation appears to make Anxiety go away, then it seems logical to avoid going into the situation in the first place. The problem with this is that pretty soon you’ve got a whole list of things that you can’t do, life becomes a misery and you still suffer from Anxiety.

As well as avoiding places or situations you might also choose to avoid opening the paper or turning on the TV or radio in case there is an item
about your phobic subject. You might avoid eye contact in social situations, or avoid using the phone or talking to people.

Avoidance is the main factor that keeps Anxiety going for agoraphobics, social phobics and people with panic attacks and single phobias. However it can also be an important factor for someone with OCD. If you know that using a public lavatory sets off a need to do rituals, then clearly you’ll want to avoid public lavatories. This is also why someone with, say, a cleaning ritual might well end up doing no cleaning at all – better not to start in the first place.

The problem with avoidance is that it means you never test out your belief that you will be anxious if you enter the situation or engage with the behaviour.

The physical symptoms of Anxiety can make you feel as if you are physically ill, in fact many people find it hard to believe that their problem is mental rather than physical. You can find yourself doing less and less because you feel so weak, tired and shaky. If you think that your panic attack is actually a heart attack, or that panic will damage your heart, you will retreat to the armchair and behave like an invalid. This is a vicious circle, because the less you do the worse you’ll feel, physically, and the less you’ll feel able to trust that your body will see you through the panic.

Nearly everyone with Anxiety has something they do that they believe keeps them safe. Someone with OCD with rituals, whether physical or mental, is doing that pretty well all the time. The trouble is the effect tends to wear off so that as time goes by you need to keep increasing the number or complexity of rituals to achieve the same feeling of safety.

People with other forms of Anxiety also have safety behaviours – always sitting by the door, always carrying your mobile phone, carrying spare
tranquillisers just in case, are good examples. Again these tend to increase with time.

There are two big problems with all of these behaviours.

Changing your behaviours will help you halt the increase and prove to yourself that Anxiety does go down in the end whatever you do. All of the behaviours have the same flaw, that is, they provide short-term relief but overall Anxiety increases.

The aim is to change your behaviour very gradually, in small manageable steps.

Make a list of your Anxiety behaviours. Follow the four headings, and add anything that you know you do even if it doesn’t seem to fit any of the headings.

ESCAPE

AVOIDANCE

DOING LESS

SAFETY BEHAVIOURS

OTHERS

You are beginning to have a clearer understanding of how your Anxiety problem affects your life. Perhaps you are realising that things aren’t as bad as you thought, or perhaps you’ve had to face up to the full extent of your illness. This is painful but important – anything that you keep in the shadows of your mind is likely to turn into a bogeyman, scaring you because you don’t understand it.

Now it’s time to look at exactly what you want to achieve. You may say impatiently ‘I just want to be alright’ or ‘I just want to be my old self again’ but you need to be more specific than that.

No one is ever entirely anxiety free. Not only does everyday life produce anxiety (Will I find a parking space? Have I got time to dash into the bank?) but there is always the possibility of an unexpected difficulty (How am I going to cope with redundancy? How can I deal with my partner’s anger?).

Anxiety is an essential part of life. It tells you when to be careful, and on the other side of the coin is your ability to feel excited about doing something new or challenging, such as starting a new job, or falling in love. You need both of those abilities.

The real problem is that your normal anxiety has mutated into an Anxiety condition, and it has taken control of your life. Wouldn’t you like to wrest that control out of Anxiety’s hands? Wouldn’t you like to be in control again?

Remember the title of this book –
Free Yourself from Anxiety
. You have the power to do it, and you are the only one who can. However severely restricted you are, starting from where you are now, you can make improvements in your situation.

At first you may feel you aren’t making any progress – but at least you will be preventing Anxiety from adding any more layers. And if you persevere, you will start to improve, however slowly. Finally, you will have learnt a set of lifetime skills that will keep you well, as long as you remember to use them.

Let’s look more closely at those impatient responses. Many people when they come for help will say:

This is all perfectly understandable, but recovery doesn’t come from aiming at this sort of goal. Remember, goals have to be SMART.

Instead you need to look for concrete, specific goals such as:

Use your notebook to write down specific long-term goals for you. Don’t let yourself become upset at the thought of how far off they seem. Instead, use the goals as your motivator. One day you will achieve them.

Next, take one of your long-term goals and break it down further, looking at what is stopping you from achieving it right now. For instance, if your goal is to get back to work you might be stopped by:

Your goals will be aimed at removing these fears from your mental agenda. They will be different for each person, because although there are broad categories of Anxiety disorder there are always differences of detail from person to person.

We aim to show you how to achieve your goals using techniques based on Cognitive Behaviour Therapy (CBT). ‘Cognitive’ means ‘relating to thoughts’ – when you filled in the ‘thinking’ section in Chapter 17 you were describing your cognitive approach. ‘Behaviour’ means just that – how you behave.

The therapy aims to help you make changes to both your thoughts and your behaviours so that you can gradually release the grip that Anxiety has on you.

We are going to start with behaviour and move on to thinking in Part Three. This is because most people find it easier to change their behaviour, at first. Sometimes just changing behaviour is all a person needs to do, but most people find that they can get so far with it and then they come to a brick wall – that is when they need to move on to changing their thoughts.

You might say, why not go straight to changing thoughts then? The answer is that behaviour does have to be changed, and starting with thoughts is too challenging for most people. It’s better to make some changes to your behaviour and enjoy the feelings of triumph that successes bring. This will help you to feel confident and motivated to work on your thoughts.