Recently I have often found myself listening to the world news and the despair that we are living through dark times. A constant feed of stories about countries riven by difference, hatred, dispute and violence, and witnessing the suffering of whole communities and populations, creates a global atmosphere of unease and anxiety about what is to come in the future.
But anxiety can also develop in our personal lives when we are faced with managing the multitude of demands of modern life. Days are busy – often hectic – and the calls on our time and energy can feel onerous and draining and leave us feeling depleted.
As well, nothing ever stays the same so, on top of coping with routine daily events, we have to adjust to the unpredictable fast-rate changing nature of our environment, our relationships, our work, our friendships.
It is easy to feel the ground beneath our feet shifting and we can struggle to hold a calm emotional equilibrium – becoming easily overwhelmed by everything that needs organising and managing. As a result, we feel stretched and stressed and on edge. Running on adrenaline, we can find ourselves on a short fuse and susceptible to mood swings.
We feel we have less resilience and, when faced with certain major life stages, even those planned and expected, they have the power to destabilise and knock us off course.
We can be surprised by our reactions to pivotal events like retirement, or leaving home for the first time, or the arrival of a new baby or, at the other end of the scale, ‘empty nest’ when children leave home. In addition we may be struggling financially and be gripped with fear of debt.
It all somehow feels overly momentous and, with our sense of security shaken, we do not always adjust well to the upheaval.
Then there are those profound events such as the terrible loss of someone we love.We can be side-swiped by waves of grief and feel we do not know ourselves any more. We feel affected for ever.
Divorce can feel like a sucker punch, as can redundancy and the sudden ending of a life-defining career – those curved balls that arrive out of the blue and propel us, unprepared, without a map, onto a new path.
There may be the adjustments we need to make when affected by illness or a sudden accident. Or the difference in life-style required when we are unexpectedly thrust into the role of carer.
Change in itself (oddly, even those changes and surprises that are pleasant or exciting or joyous) can leave us uncertain and fragile.
Life continues on but, as with a kaleidoscope, we know that the pieces have shifted and moved and have taken on a different colour and hue. We do not recognise the new shapes and patterns and we may not be able to rely on the same hand-holds and support.
Chronic Generalised Anxiety
We all hope we will eventually emerge on the other side with renewed purpose.
However, we may not recognise that what was once a helpful and appropriate coping mechanism to a challenging situation has morphed and become dysfunctional. The ‘off-switch’ has not been flipped and we are stuck in the grip of anxiety in overdrive. Anxiety flows as a constantly present undercurrent in life.
We can be left feeling deeply troubled but we may need help to acknowledge that it has become a chronic state and that the symptoms are worrying enough to indicate we need support.
– In a way that we would not downplay a physical ailment, we may dismiss our mental health and the help we could receive from the GP – perhaps discussing seeing a therapist or starting on a short course of medication.
– We may deny that we are not managing, unfavourably comparing ourselves with others who seem to be coping, and conclude we are not deserving of compassion.
-We may be self critical and feel we should ‘step up’ and stop letting down others, feeling we have to soldier on.
– We may minimise the impact of becoming more withdrawn, insular and isolated than usual, accepting and feeling resigned to, the ensuing self-imposed limitations on our lifestyle.
– We may feel stuck and risk-averse but embarrassed by our nervous and apprehensive reactions to what were once ‘ordinary’ social events. We are practised at avoidance and end up distancing ourselves from family and friends.
– We know we have less confidence and less trust in our ability to deal with ‘Life’. But we hide any distress as best we can and side-step potential challenging situations.
– We can develop an overall pessimistic and negative outlook but deflect and justify, excusing it as ‘normal’ given external events.
The Experience of Anxiety
We have all felt the butterflies that come with nervousness before an interview, or a performance, or an important game, or even the dentist or a medical appointment. However, while in the moment there is a rush of adrenaline, it is situational and temporary. Once the event is over we quickly calm down and recover our sense of wellbeing. Our brain is doing what it is meant to do to protect us.
- However, brains can misfire and it is very different when, although no actual threat exists, the brain is unable to switch off from a state of high alert and vigilance. It has a fixed perception of danger, remaining in a heightened state of ‘Flight, Fight, Freeze’, continuing to pump out high levels of cortisol and adrenaline.
- The anxiety volume control is stuck on ‘loud’. We are unable to flip the ‘off switch’ and, with a baseline of adrenaline remaining elevated, we are left fraught and out of sorts and, sometimes, quite unwell.
- We can feel jittery and shaky with symptoms such as high blood pressure, palpitations, queasy stomach, insomnia, rigid tense muscles, back pain, rapid and shallow breathing. There have even been occasions when the symptoms of a panic attack have been confused with a heart attack.
- Our sleep and appetite are affected, as is our concentration and ability to function effectively.
What To Do
It can be reassuring to know that a brain can be taught to respond differently to distress and that well-proven strategies exist that help to manage overwhelm and panic.
It is possible to have a toolbox of interventions that work effectively as ‘circuit-breakers’ to prevent a downward spiral into despair.
It is not about ignoring anxiety but about becoming skilful in what are fairly straightforward techniques to calm an overworked nervous system.
Breathwork
When anxiety is triggered our breathing can become fast and shallow and I often suggest using a ‘controlled breathing’ technique as an early intervention. There are many methods so experiment to find the one that works best for you.
To start I recommend placing one hand on your heart and one hand on your middle so you feel your diaphragm rise with the first deep intake of breath and fall with the exhale:
- 4-4-4-4: Visualise moving around a square to the count of four. Breathe in for four seconds. Hold for four seconds. Breathe out for four seconds. Hold for four seconds. Repeat
- 4-7-8: Breathe in for four seconds, Hold for seven seconds. Exhale for eight seconds really emptying your lungs. Repeat
- The ‘Sigh’ breath: Take two short inhales. Hold. Then one long exhale. Repeat
Relaxing muscle tension
Gentle movement exercises to identify where you are holding the stress in your body and how to let it go.
- The head roll: Sitting comfortably, tilt your head forward and slowly roll it clockwise. Return to the centre. Tilt your head forward and slowly roll it anti-clockwise. Return to the centre. Repeat
- Progressive Muscle Relaxation: Moving from the top of your head to the tips of your toes tensing and relaxing each group of muscles in turn.
- The pump: Stand with your arms relaxed by your sides. Breathe in. Clench your hands into a tight fist. Then release, spreading your fingers wide, while exhaling. Repeat
Exercise and movement
Movement can be a good friend.
Put on your trainers or outdoor shoes when you first get up in the morning so, when the urge is to slump on the sofa, you are more prepared to make the effort to step outside instead.
Changing your environment can allow a mental shift.
Try to create a routine of leaving the house by asking a friend to call for you and take a short walk together.
Break up the rhythm of a stroll by walking at a brisk pace for one minute, then slow down for one minute. Repeat. Build up by adding an extra minute.
Join a walking group, or a yoga or tai chi group.
Grounding
Tactile stimulation can shift your focus. Stay with an awareness of the present moment by with a focus on the five senses
Sight: Lift your eyes and look at the sky. Look intently and note the colours and shapes of the clouds
Smell: inhale something pungent. A favourite perfume, or lavender or eucalyptus, or lemon balm, or fragrant flowers and leaves, or the muddy earth.
Hearing: Listen to a playlist of favourite tracks. Choose music with which you have a connection. If outside, identify and label five sounds that you can hear in the background.
Taste: Keep a a mint or sweet (even chocolate?) to hand and focus on the flavour. Even with no appetite, taste food slowly and mindfully.
Touch: Squeeze on a squishy ball, kneed some dough, run your hands over the bark of a tree. Keep a smooth pebble in your pocket to turn over in your hand. Notice the sensation of wind or the rain or the sun on your face.
Anchoring
Being able to recall and hold a positive image or memory can alleviate the despair of an overly negative mindset. When there is a tendency to catastrophise, it can help keep perspective.
Practice visualising a place you associate with being safe and cosy.
Or recall a time in your past when you felt easy and relaxed, or a moment of laughter, or a time of contentment,. Stay with it.
Concentrate on holding the image while pressing your thumb and first finger tightly together (to make an O) so gesture and image are associated. Consciously store the image and give it a name so you can recall it in the future using the same gesture.
Reality Testing
Reduce the tendency to overgeneralise by looking at the bigger picture. What is fact and what is unsubstantiated fear? What do you actually know is reality and what is fearful trepidation?
Is there a different and alternative way of interpreting the situation to shift focus away from a doom laden perspective?
If it was happening to a friend what would you say in order to support them? How would you reassure them? How would you comfort them?
Can you say those things to yourself?
Write these consolations in a notebook so you can refer to them again.
Recall the coping mechanisms have helped you in the past and write them down too.
What suggestions do you think someone who knows you well and cares (or your doctor, or your therapist) would make to help you challenge all-or-nothing thinking? What alternative perspective and reassurances would they offer?
We are not looking to eliminate anxiety. When appropriate, it serves us well. But we can learn to keep it under control in order to enjoy a calmer, more relaxed lifestyle.
Kathy Rees