Advice on Dealing with triggers

[scrumking]

I know everyone has their own triggers but how do you deal with them? Maybe I'm doing something wrong?

My trigger is the daily bus commute to and from work, I have had some of my worst panic attacks on the bus and every time I am standing in line waiting for the bus my hands start to sweat, heart races, dry mouth, all those panic responses we all know and hate so well. The 20-25 minute commute is my version of what hell must be. I have had such bad attacks that I have gotten off early to either walk home or stupidly wait 30 minutes for the next one that time spent panicking about having to do it all over again. They say that exposure is the best best medicine well for the last year I have exposed myself to it 5 days a week twice a day and it still happens EVERY TIME!!!! Any ideas or suggestions?

On a side note I read something very intriguing last night and basically it said don't own your anxiety, the premiss is simple every time you say the words "my anxiety" you are referring to it as something you "own" instead try saying "the anxiety" then you are referring to a thing not a possession. Possessions you own things come and go!

[mummyanxious]

Mine is the school run even though I like it??? And I could have written those exact words. Will watch with interest.

[SarahH]

Mindfulness:)

[cpe1978]

I guess it depends what you mean by triggers. I can't pin point something in particular that makes anxiety rise. However over time I have sort of learned to sit with my anxiety rather than respond to it. I dare say there will come an occasion where that is difficult or impossible, but for the most part it allows me to feel anxious but not respond negatively to the feelings and enter a spiral. More often than not it passes and I carry on.

[MyNameIsTerry]

I think the duration may be a problem in terms of exposure. If you look at Exposure Therapy, they aim for habituation and the charts show the points vs the number of minutes when panic triggers the need for escape. The duration of your commute is short in terms of exposure time (Im sure it feels like its never going to end though)

What is it exactly that makes you anxious, issues at the other end or maybe being trapped on the bus?

I agree with SarahH, Mindfulness meditation can be practiced on a bus, in a queue, in a waiting room, etc. You have to learn how to do it effectively in a safe place first though before you move onto more distracting places.

[mummyanxious]

MNIT is right. I'm pretty certain I read the other week that exposure therapy is liking going into a shop for two whole hours. As the waves of panic will come and go.
Having said that I was stuck in a social situation for 5 hours yesterday and felt retched. Only started to relax a bit around half an hour before we left...

[MyNameIsTerry]

I will find you the article and post it back on here in a bit for you MA.

I wondered who MNIT was for a minute there!

---------- Post added at 05:18 ---------- Previous post was at 03:09 ----------

MA - slide 46 of this .PPT was what I was talking about. I haven't read through this presentation though so I can't speak for the quality of the rest of it.

http://www.google.co.uk/url?sa=t&rct=j&q=&esrc=s&frm=1&source=web&cd=4&ved=0CEoQFjAD&url=http%3A%2F%2Fwww.vrphobia.com%2FResearch%2FPub lications%2FWorkshops%2FPart%25201.ppt&ei=98cvU9yzB8eShQe4mYCoDg&usg=AFQjCNHBx4MC6Bcfbhqm64XzugNQUT83FA&sig2=rP2f9MYuaSaGZ5_xZ2rDtA

When I had CBT, I was shown a chart depicting panic in an exposed situation. I tried to find this for another thread but the other poster and I had only been shown them in CBT sessions and didn't have a hard copy. I couldn't find the diagram via Google either but if anyone's having CBT, ask to see it. It showed a very high anxiety spike within minutes of entering the situation but then after so long is decreased rapidly (I think 20 minutes, PA's are usually 10 when they reach full throttle) and it also rose again but to a far lower intensity within X minutes of leaving the exposed situation.

So, it may mean that Exposure Therapy is for prolonged situations and shorter durations may not help you habituate to them. I'm not sure on this, there may be another method within this to do it, it's what I took away from my CBT.

---------- Post added at 05:27 ---------- Previous post was at 05:18 ----------

Found something similiar.

It looked like this except it decreased more sharply from the first peak and the next peak was where the 20 minute mark is on here. On this one they are applying various stimuli throughout hence the multiple peaks which were not present on the one I saw.

http://travisithompson.blogspot.co.uk/2011/12/obama-re-election-campaign-stop.html

[HoneyLove]

Hi scrumking, you need a technique to help yourself feel calm again in situations like this. A CBT therapist gave me a very simple one that you can use in public, people will never notice it. It's a simple breathing exercise, but it works very well - it will changes the levels of O2 and cO2 in your body to ones that will help you relax and climb down from that anxious place.

All you do is breathe in for 7 counts, hold for 2 counts, and then breathe out for 11 counts. It doesn't have to be a really long breath, but just one that is comfortable where the out breath is longer than the in breath.

As well as working on the levels of gasses in your body, it will take your focus away from what you're worrying about and centre it on your breath - it's a handy trick to distract yourself from the anxiety and return your focus to something calm and centering.

Give it a try, it's really handy for public transport, I used to do it all the time back when I was at the worst of my anxiety. I still use it sometimes if I'm feeling overwhelmed.

[Female healthanxiety]

Hello ScrumKing,

I feel for you... I know exactly how you feel.

I could never get on a bus or a train, and I too would get off early.

the trick is to keep on doing your journey. Listen to some relaxing music, and try and distract yourself from how your feeling, ie, do your shopping list, read a paper or magazine, and whenever you feel like your getting anxious have some water.

Things will get better xxx

[MyNameIsTerry]

Hi scrumking, you need a technique to help yourself feel calm again in situations like this. A CBT therapist gave me a very simple one that you can use in public, people will never notice it. It's a simple breathing exercise, but it works very well - it will changes the levels of O2 and cO2 in your body to ones that will help you relax and climb down from that anxious place.

All you do is breathe in for 7 counts, hold for 2 counts, and then breathe out for 11 counts. It doesn't have to be a really long breath, but just one that is comfortable where the out breath is longer than the in breath.

As well as working on the levels of gasses in your body, it will take your focus away from what you're worrying about and centre it on your breath - it's a handy trick to distract yourself from the anxiety and return your focus to something calm and centering.

Give it a try, it's really handy for public transport, I used to do it all the time back when I was at the worst of my anxiety. I still use it sometimes if I'm feeling overwhelmed.

Yes, I had that one from my CBT therapist. I believe it was called Calming Technique.