If it is nearing time for next scheduled dose, adv

Depression is not just a case of feeling low, or of needing to cheer yourself up. Because you need to do exposure every day, most rewards will be small treats that are easy to arrange and not too exsive. Find out what works for you and stick at it, dont ease off on the practising when you start to feel better. My advice for people about to start on recovery from anxiety is get a healthy diet, take exercise, make sure you know what your needs are and how to get them met. Dealing with plateaux and setbacks For both plateaux and setbacks there are various things you can try: Take a break Did you attempt too much and tire yourself? Visit supermarket at busier time, with a helper, and buy one item, and so on. Your high anxiety makes it more likely that you will find yourself unable to say or do the things that you feel you should be doing, and more likely that you will continue to worry after the event that you have done or said something wrong. 8 is a comfort number for me so I used to check it 2 by 8 times, and I had to go through the count without blinking. Lets look at the example of someone with social phobia. The turning point came when I realised that the therapist had the confidence that I would make progress. In Part Three you will learn how Anxiety affects your thinking, and learn some techniques for reducing anxious thoughts. Finish by pushing your stomach up a little to push out the last of the stale air. Harder. At the top are the automatic thoughts that pop into your head when youre feeling anxious. In both cases your attention is selective – either focusing on the negative, or the positive. If your Anxiety causes you social difficulties then dont torture yourself by attempting this one – its meant to be a pleasure, not a pain. Reassurance – simple phrases such as you can do this or take your time. No wonder you feel like staying in your safe place and doing as little as possible. But it has to be a particular one. Behaviour: you may avoid certain places or situations, or you may have to complete compulsive rituals Whole self: you may have poor self-esteem, fuelled by underlying beliefs about yourself. 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 details of the verdict will be different for each person, since Anxiety doesnt treat us all the same. Another good technique is to work with another person and ask them to repeat your counter statement to you, while you return the favour and repeat their counter to them. I tell myself I can only do so much. The trouble is that the beliefs dig themselves in and hang on into adult life like bad habits that are hard to change. You dont have to do sports, and you dont have to join a gym. No one was expecting it, we thought it was just a kidney infection. Behaviour: clean everything every day and clean toilet at least 10 times, more on bad days. You will need to know how to cope – because you can cope, even though at the moment you think that you cant. At one time I exercised too much and it made me ill, but it helps to go for a run or a walk to take my mind off anxious thoughts. Here is an example for someone with a fear of losing control and harming another person. By reading their stories we hope you can see that Anxiety is an illness that strikes ordinary people. You may also have underlying emotions, such as anger or grief, that you are not able to express oly. I called him Pat and it was 22 steps from my front door to get to him. We suggest that you dont think at all about the ultimate goal at the moment. 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). Dont get bogged down when you use counters – counter each thought once, and then move on. This disorder usually happens sometime during early childhood or adolescence and continues on throughout adulthood. The only way to find out is to try – and in any case you will benefit from having a healthier lifestyle. Treating yourself as an invalid (e.g. avoiding any exertion in case it brings on a heart attack). Exercise is helpful in several ways: It helps burn off muscle tension.

In Part Three you will learn how Anxiety affects your thinking, and learn some techniques for reducing anxious thoughts. Understanding compulsions There are often two elements to compulsions: Sometimes, however, there may be larger issues to face. With tranquilliser withdrawal you have to let your body heal itself. . Repression and anxiety There seems to be a connection between repression and Anxiety, and anxious people often say that they find it hard to express their feelings, especially anger, grief and despair. Dont include anything negative. Creating an activity diary – plan activities that are more satisfying to you. I dont like having to negotiate to get what I see as my right. I do find it difficult to be assertive – its hard for me to say no. I have searched for guidance in the form of confidence and assertiveness classes. I used to find it difficult to be assertive but not now. How you provide support to them may help them to control their Anxiety to some degree. Someone with OCD may have problems with what they perceive as a dirty environment both while travelling and while at work. One answer is to look for other situations that imitate the one you fear. However, fight-or-flight is controlled by your involuntary nervous system. Similarly, you may find yourself facing great difficulties in a relationship. Close your eyes, and focus on the word relax. Many Anxiety sufferers are very busy people, juggling family commitments, work and Anxiety in one endless rush. What do I do because of my fears? To have ANOTHER ATTACK! What would be the worst that could hap? The next step is to test the theories in a live situation. Achieving successes in exposure work.

At first I could only take three or four minutes but I gradually got it up to the full 20 minutes. These kinds of beliefs are self-fulfilling – if you believe that you cant cope, then the chances are that you wont cope. Refer to specific behaviours rather than making sweeping statements. Someone who suffered a setback when reducing the number of times they checked their cooker changed to the goal of restricting the amount of time they st checking – later they were able to return to the original goal. Breathe in and allow your stomach to expand like a balloon as you fill your lungs with air. I just want to be alright – can you define alright? Facing this possibility can feel very uncomfortable, after all you give over a large chunk of your life to OCD rituals, do you really want to find out that it was all pointless? Disadvantages of change. Dont dismiss this, or feel ashamed of it – but do use countering statements to help the frightened child in you let go of its extreme thinking. Social phobia (also called social anxiety disorder) This is a complex condition, covering a range of fears to do with behaving or performing in front of other people. You are in control of your recovery. Recovering from your current bout of Anxiety There are a lot of different techniques explained in this book. It helps you to take better care of yourself in a dangerous situation and it can help you perform better, for instance in an exam or public performance. Feelings of inferiority and low self- esteem, which I largely attribute to my up bringing. There are any number of ways of describing what goes on inside a persons head, i.e. Its easier though if you find something genuinely funny. Training for these events provides a focus to keep up my fitness. If you fail at one of your goals, dont let yourself plunge into despair. I made really good improvement, I could still improve but the vast majority of the time it isnt a problem and I can live my life quite comfortably. When you set up a recovery programme you aim to work steadily, curbing your impatience and taking one step at a time. This is the crux of my OCD. And it doesnt make your Anxiety go away.

What have I stopped doing as a consequence of my fears? Despite this, many people feel guilty about taking care of themselves. That’s their job! At the onset of panic, breathe out into the bag, then breathe in from the bag. A person with OCD has to find a way to stop doing their compulsions – they have to stop doing something they do want to do. I know that most people actually dont have accidents, but I dont know how they stop themselves worrying about it. If they are afraid of travel, they need to practise travelling. Dont include anything negative. (Of course for anyone who does experience this, it is a sure sign that they are sensitive to caffeine and would be better off without it). They may be compulsive in searching our doctors to treat them with medications and/or plastic surgery. Rewards can also be incorporated into the exposure work, so that you may set yourself the task of going out to buy your favourite magazine, or use the time freed up by not doing rituals to watch TV. Unhealthy breathing, as you already know, only uses the top section. Key skill – accepting change The first key skill is accepting that change is necessary. If you experienced trauma as a child and you havent been able to deal with it, then you will still be carrying the pain of it and that may well be feeding into your Anxiety. There are three ways that Anxiety helps this process: If you are afraid of flying, you wont be able to get on a plane every day. Its as if a small voice inside you has been asking for your attention, and when you ignore that voice it eventually decides to yell and shout, by hitting you with a panic attack, phobia or compulsion. He became an alcoholic by the time I was 13 years old. We were a fairly relaxed family on the surface. The techniques we describe will still work for you. Similarly, someone with deeply held beliefs will feel stronger physically and happier in themselves.

Id tell them not to be so hard on themselves. Also you can look into the past – worrying that you made a bad job of something will cause you to try harder the next time. ABOUT THE RECOVERY PROCESS Ive now come to realise that no magic wand or quick fix exists. Im very up and down, sometimes I feel Ill never get better. If you get those signs again, youll recognise them and, even better, youll know what to do. Simple tasks like helping put on a school tie would trigger off my imaginings of strangulation and panic would engulf my whole being.In this section, we are going to put your Anxiety on trial. Your high anxiety makes it more likely that you will find yourself unable to say or do the things that you feel you should be doing, and more likely that you will continue to worry after the event that you have done or said something wrong. If you dont have money worries, or physical health worries, and if everything you want is right there for you, you could well feel guilty about acknowledging that you still arent happy. Each ladder has to be individually tailored. Filtering I had a bad day yesterday, Ill never get better. OCD is caused by Anxiety. ABOUT ANXIOUS THOUGHTS OCD is like superstition where you worry about the consequences of things in a way thats basically irrational. In fact, instead of underestimating my ability to cope I sometimes overestimate it! I was constantly on the alert, watching my anxiety to see what trick it would pull next. Now are my feet in the right position? It frustrates me to see other people making the same mistakes I did. Picture a scene at the Old Bailey. I just want to be alright – can you define alright? Even if the blood test has to wait for another visit, you will have made your first steps towards recovery. Obsessive thoughts about harming someone or doing something immoral or taboo, may lead to compulsive thoughts about prayer to cancel out the obsessive thoughts. Name-calling We all beat ourselves up from time to time, using words like fool, idiot and maybe a few unprintable ones too, but Anxiety can persuade you to be far too hard on yourself, so that you constantly think things like Im so clumsy, so lazy, so forgetful and so on. As we go through this information, I want you to understand that this section is of importance to those trying to help another person who is experiencing, or dealing with, Anxiety on a daily basis. There will always be some people that dont like aspects of your character, but that doesnt mean youre unlikeable as a person. You may recognise this mindset if you have ever been a parent, or worked with children. Youve started to work towards recovery and however tough things get, you can find a way to keep going.

Developing assertive communication Here are some basic rules for this type of communication: Perfectionism: Its okay to make mistakes, I can learn from them. Creating an activity diary – plan activities that are more satisfying to you. & eating something within 20 minutes of waking up & breakfast, either then or not long after & mid-morning snack & lunch & mid-afternoon snack & dinner & light supper & avoiding sweets and chocolate & avoiding cakes and biscuits & avoiding caffeine & eating fresh fruit and vegetables & eating a wide variety of foods & drinking plenty of water Use your goal setting skills to make these changes. You may be unable to leave home at all, or you may be able to travel within a familiar circuit, knowing that you can return easily. At first I could only take three or four minutes but I gradually got it up to the full 20 minutes. But, because Anxiety is one of those ‘sweep it under the carpet’, “embarrassment-type-I-think-I-might-be-going-crazy” disorders, people don’t like to talk about it. And what haps if you work through this process and are dismayed to find that the wrong item has the highest score? Spiritual: I know that Im responsible. In particular, use it when you are in a situation that is difficult for you, where you might panic or become very anxious. I suspect dad was suffering from bi-polar. Oh God yes. 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. Why not try to help yourself in the meantime? Why not try to help yourself in the meantime? Avoid drinks containing caffeine and alcohol. Sometimes resistance to recovery comes from your core beliefs. It helps to talk to someone about this, and if you dont have someone you can confide in, then use a helpline or online service (see Apdix 2 for details). Lets look at the situation objectively. If you have a bad Anxiety day, take extra trouble with this, but try to calm yourself before you pick up the notebook.

Even if you havent been through stress like this, the effect of Anxiety is to make you fearful of change. If at all possible I preferred to tread on uneven ground because this made me concentrate on where I was putting my feet. For instance, heres how the circle might work for someone whose core belief is Im useless: They feel their heart thumping, and their breathing get faster. 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. Were you happy and fulfilled? When the crisis is over, you are released from the need to deal with the immediate problems. Tell yourself that one day you will be able to go out and take part in other activities, and exercising in the house is part of your training for that goal. The important thing is that you now understand what you need to do, and you have learnt not to be intimidated by the size of the task, because you know that small steps are best. This starts in childhood and can come from: parents who are too critical significant loss (for example of a parent) during childhood physical or sexual abuse neglect rejection parents who are too protective parents who are too indulgent. but there is always the possibility of an unexpected difficulty (How am I going to cope with redundancy? Recently Ive found yoga very helpful, specially the breathing. I was admitted to hospital when I was 16 after taking an overdose. Bulimia Nervosa – periods of overeating followed by vomiting or purging to control weight alternate with periods of starvation. What are the chances of this haping, or of this being true? I was standing in the queue at the bank when I suddenly felt terribly sick, my heart started pounding and I felt like my legs wouldnt hold me. If you need to describe a continuous feeling, again keep it simple: I feel so shaky every morning that I just cant get out of bed, and I get worse as the day goes on. I keep needing to check that the smoke alarm works, I know it does, but sometimes I go back 20 times to it. Response prevention is a technical term used in clinical treatment for OCD but it doesnt mean you have to stop completely all at once. Stopping rituals and compulsive thoughts Your helper can use the same techniques described above for helping with panic and phobias: Grounding – remarks that remind you what to do such as just breathe out slowly or you were going to stop after ten minutes. Reassurance – simple phrases such as you can do this. Feeling unreal Some people describe a strange and scary feeling of being not quite there, unreal or not in my body properly. I relax in a conscious way at bedtime when I turn the light off. It was like I was in a play and I had to play the part well. The perfectionist The desire to improve is one of the bedrocks of human progress, and there are times when a perfectionist streak will lead us to achievements that we never thought were possible.

If you have an Anxiety disorder you are not odd or strange, and above all you are not alone. And another example from someone with OCD: Physical: feel better doing rituals, apart from knot in stomach. I still monitor my breathing on bad days and now its much slower! Ive worked on my breathing – the hospital taught me to blow bubbles. Automatically they think its panic – what if I cant handle it? Their underlying assumption causes them to think I should be able to handle it. Their core belief causes them to think Im useless, I cant handle it, I need to get out. They then leave the situation because they believe they cant handle the panic. Another approach is to set aside times for worrying: Worrying allowed on the hour, every hour, for ten minutes. Someone with OCD is likely to attach enormous importance to thoughts of this type. If you can’t lay down, sit still, close your eyes and focus on slow, even, breathing. Sometimes you may need to try more than one anti- depressant to find the right one for you. No one was expecting it, we thought it was just a kidney infection. If you get those signs again, youll recognise them and, even better, youll know what to do. This simply isnt true. I also tell myself how much time I can sd on something, and that helps me to stop and walk away from it. Its easy for any of us to develop the habit of using the expression what if? This is where we need to change our habits and replace this expression with the words so what! Consider the following question. Breathe out. ABOUT TREATMENT I tried hypnotherapy in my teens. The next step is to give points out of 10 for each of the items on the list for the two holidays, as follows: At this point there isnt much to choose between them. Your brain has been busy at such a deep level that you arent consciously aware of the thought processes, but nevertheless there are thought processes, and Anxiety can bring its influence to bear on them just the same as any others. NEVER belittle or try to downplay someone’s Anxiety Disorder. 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. This means that change is going to hap anyway, whatever you decide about undertaking a recovery programme. Feel the difference as your chest muscles relax.

Chronic fatigue syndrome (Myalgic Encephalopathy or ME) This illness is known by various names, these being the two most common names. If your attempts to do more are constantly interrupted by worry, you can create an exposure ladder to help you reduce the time you sd worrying. Or you may feel a deep resistance to it. Learning to accept risk This exercise will help you to assess risk objectively. Socratic argument and OCD Using the Socratic questioning technique can be very helpful in breaking out of OCDs illogical thoughts. Examples of complex emotions are love, guilt, embarrassment and jealousy. For instance, heres how the circle might work for someone whose core belief is Im useless: They feel their heart thumping, and their breathing get faster. In the lift example the person might set boundaries in this way: In other words, theyve misinterpreted the fact that you avoid socialising because of your Anxiety. I was frantic with fear at this terrible thought . The REAL trick in battling Anxiety is to redirect your train of thought. Dont get thinking of that again. It can help to have someone else show you how they complete the task within a normal timescale, but dont ask them to show you every time, just once. It will be difficult to find enough time at first, but gradually you will turn things around, life will be less fraught, and you will have more time available. What Causes Anxiety? Sometimes you will see the word holistic applied to therapy. Growing as a person and developing unused potential As you look deeper into the causes of your Anxiety you may feel the need to make changes in your life. Start from wherever youre at and take the first step. Looking at Change and Risk Weve already explained the key skills of relaxation, basic calm breathing and goal setting. And you could say that behaviours such as constantly checking a room for spiders, or crossing the road to avoid a meeting, have an element of compulsion to them. Although the thoughts and rituals may seem quite strange, psychologists believe that they developed for good reasons – usually as ways for a child to get through a difficult situation.