Things to help with anxiety?

[trojax1]

Hey, I've been writing in a diary about things that get me anxious for my therapist and it was good at first having these things written down then going through them with my therapist. The only thing is that im not really into it as i was at first and it doesn't feel like its doing much for me now. I was just wondering what thing people do to help with anxiety which is kinda like this. Something you can stick to daily or whatever really.

[Bill]

I think I could probably make a list of things but some things will depend on the type of anxiety.

For general anxiety, these are the sort of things that have helped me...

When you hear, see or think of something that worries you, Don't dwell on it. The more we think about whatever it is, the more we analyse it from every angle until we feel completely stressed out by it. IF it's something you can't do anything about, let it "go". Let it pass through you like any other thought. If it's something you can do something about, then think positively on a plan that would sort the worry so it's no longer a problem.

Find an interest. A hobby. Something that when you first wake up will make you look foward to doing. Life can be boring and tedious, and when living becomes a matter of just surviving, we become depressed so upsetting things we encounter will bother us more so we start dwelling more because we have nothing to look forward to!

When something troubles us, we need an activity to stop us "thinking" because when we stop thinking about a worry, our body stops reacting to our worrying thoughts so we end up staying relaxed.

If you're in a boring job, think about finding an enjoyable job because boredom creates stress which leads to depression and health anxieties.

Keep stress in your life to the least possible by identifying the causes and producing a plan to ease them.

Too much stress in our lives creates tension causing panic attacks because we end up feeling trapped which is why often panics occur in crowded situations or in a small room. It's the stress in our lives that surfaces making us feel the need to escape.

Too much stress will also make us feel like a parrot in a cage so we end up puling our feathers out by creating health worries because we feel trapped.

Stress though can be in two forms- stress in our lifestyle and/or emotional stress caused by bad experiences. In some ways the two are tackled differently.

If you feel stressed in a certain situation, learn a relaxation technique or a distraction method that you can use to get you through it.

Don't think "inwardly" about your own feelings and thoughts but instead look for things around you that will make you think of other things such as a picture on a wall or what others are doing.

Make a list of anxieties that trouble you and scale them one to ten. Tackle the easiest first because as you tackle each one, your confidence builds so that by the time you reach the hardest they've become easy too.

Build confidence- we are often sensitive and lack confidence. If we "gradually" confront our fears, we gain confidence and feel more capable in our own abilities.

There is a certain way to confront fear- people often say they feel worse by confronting their fear. This is because they tense up at the mere thought of the challenge. Confronting a fear means learning to stay relaxed "before" and "during" the challenge so that it's not an ordeal. Only then do we build confidence.

I think that's enough for now!

Anxiety affects people in different ways so although there are "general" things that can help with symptoms, the only real way to tackle our anxiety is to identify the causes to help us understand why we feel so anxious. If we understand ourselves, we gain knowledge and that knowledge then helps us to formulate a plan to tackle our specific anxieties. We may all suffer from the same anxiety symptoms but the causes can be entirely different and it's the causes that really need to be dealt with rather than the symptoms they produce.

[orchid]

Hi Bill, you seem to know what you're talking about! Do you mind if I ask you a question?

Whenever I have had anxiety in the past I know it is fuelled by ruminating, worrying about and analysing my scary thoughts, which have little or no real relevance to what I actually think and feel in reality. It makes me feel crap, and when I finally stop doing it and get on with life, be kind to myself etc. I feel better, and that lasts a pretty long time (months), until life's stress finally catches up with me again. When it does, I decide I must have been tackling things the wrong way for it to have caught me again, and start looking for other ways to deal with it. This of course starts me ruminating again and the anxiety comes back and off we go!

The thought that always nags at me and starts me thinking again is that if you have anxiety you have to 'face your fears'. But I don't have any daft phobias about mundane things that would stop me living a normal life, so I end up making myself imagine all kinds of horrible, unlikely, nightmarish stuff, which I do not and should not ever really face in reality, and of course it makes me feel utterly miserable. At this point my common sense tells me it's rubbish and I should ignore it, but my anxiety says 'no, you mustn't avoid it, pay attention! sort this problem out!'. This plays out for several weeks until I decide it's making me miserable, and I go back to ignoring it, living life and then it fades away. But I always have this nagging doubt that I'm just avoiding things or 'cheating'.

Does this make sense? I guess what I really find with advice on anxiety is that so much seems contradictory or finely differentiated. What's the difference between sensible ignoring/not ruminating and harmful avoidance of a problem?

What should I really do? Face my fears by imagining the worst possible things I can (or even making myself face real horrors/danger)? Or is that the worst thing I can do? Should I instead ignore and try not to think such things (obviously not try to force them out if they come though). Or is that avoidance?!

I am so confused about this. I think I know in my heart/common sense what to do because it's worked before - get on with life, ignore the silly thoughts and they will fade. But I just feel I can't trust this because I worry that's not doing it right and ignoring the problem! Gah!

Can you or anyone else help?

Many thanks!

[Joellie]

I wish i could but i see so much of what your going through happening to me. You say about how you pick at things that in real life you dont feel the same for. I have this and i cant litterally stop worrying. Once im over the thing i was worried about it starts all over again. I feel like i cant move on with my life.

[Bill]

Orchid (my favourite indoor flower! ) and Joellie

I'm more than happy to Try and help you as I am for anyone who thinks I might have something helpful to offer. It's the main reason I came here.

I think I'll have to take each bit at a time and then sum up....

analysing my scary thoughts, Never analyse. Just treat them as "silly thoughts" created by your fear. Don't "allow" them to be scary. Just treat them as "silly" and laugh them off. Difficult I know but they only keep coming back because they know they can scare you!

when I finally stop doing it and get on with life, be kind to myself etc. I feel better, and that lasts a pretty long time Exactly what you need to do All the time.

until life's stress finally catches up with me again. I feel stress of whatever type whether it's from past traumatic events or stresses in our lifestyle in the present will often trigger our anxiety. We have to try and find ways to limit the amount of stress in our lives and when at times too much stress becomes unavoidable, to learn how to remain as calm as possible under pressure. Building confidence and learning a relaxation technique will help.

you have to 'face your fears'. But I don't have any daft phobias about mundane things that would stop me living a normal life, so I end up making myself imagine all kinds of horrible

It's true to say that facing our fears can help us overcome them but there's a right and wrong approach. The wrong way is to put ourselves into a terrifying position and panicking ourselves senseless then feeling a failure. The right way is to be able to "hold a spider feeling calm and relaxed without feeling any fear" because we learn to not allow the "spider" to frighten us. In other words, Before and During facing a fear, it's vital to remain relaxed and let the fear pass through us with a "carefree approach". Once we prove to ourselves the only fear that exists is the fear of "feeling fear" that we create, the situation or thought never troubles us again.

In CBT they will tell you to think or hear the "worst" to de-sensitise you from the fear the subject creates but I feel it only works once we learn to not allow the subject to frighten us by remaining calm at the thought or in the situation. In other words, there's no point thinking the worst and panicking every time because it'll never work until we learn not to be afraid of it. The theory is that we become bored of hearing or experiencing the fear and yes, I can understand how this can work. CBT only works though if the sufferer learns how to use it and is prepared to have faith in it and in themselves.

Should I instead ignore and try not to think such things (obviously not try to force them out if they come though). Or is that avoidance?!

This is right and wrong. Yes, you should ignore but no, you shouldn't try Not to think them because that's trying to resist them. Let them in and let them out again by learning to "ignore them" After you've thought them. Avoidance is trying to stop yourself thinking them. Once you learn how to not let them worry you, they'll stop attacking you because they'll know they can no longer scare you. It just likes to bully and when it knows it can, it keeps coming back. Don't let it by saying to yourself "you can make me think whatever you like but you're not going to worry or frighten me because I don't care!"

If I've left anything uncovered or you've more questions, please feel free as I'm more than happy to offer my opinion.

[orchid]

Thanks Bill, that's really helpful.

One thing I want to be clear about - it is only really extreme thoughts that upset me and make me anxious. I don't really have anxiety about normal activities any more, and if I do, I've learned to live with it, float through it, and get on with it!

Let me give you an example. Earlier this year I was under a lot of stress and started feeling down. One night when I was struggling to get to sleep I had a horrible thought about whether I could harm myself with a knife. It was utterly abhorrent to me - I know deep down inside me that is one of the worst things I could imagine, it is nothing like me, and nothing I would ever want to do. But it scared me so much. For a while I felt anxious around sharp knives, just in case something terrible happened. Now, months on, I have got used to them again, and can use them relatively calmly and unthinkingly (not quite as carefree about it as before yet, but it doesn't stop me). I feel I am almost over my anxiety around them, and that I could be, but for the only thing keeping it alive which is this idea that I really have to 'face my fear', and that this would involve holding one against my skin, because that approximates to my worst fear. :-(

I KNOW I am always in control and would not want to hurt myself, but this whole thought just feels totally abhorrent to me. It sounds crazy, and potentially dangerous if I were to slip or something! My common sense is telling me this is a stupid thing to do, a normal person wouldn't ever want to do it for the same reasons, but my nagging doubt tells me I have to 'face my fears' so choosing not to do this would be avoidance :-( The fact that I have read about a few people undergoing really extreme therapy like this for OCD compounds this. 'If they've had to do it, maybe you do too'. I can't believe such a scenario is really used as part of therapy - just like getting people with contamination fears to rub dog muck on themselves, or (as I heard from Jo Brand on QI) getting a woman with a phobia of sperm to sit in a bath of the stuff! I mean, that just seems cruel and ludicrous to a normal person (as Bill Bailey said in response - he's rather just have the phobia!) Is it just that nothing else has worked with them, and that it interferes so much with their daily lives (unlike in my case) so therapists have to resort to such extreme methods to have any effect on them (unlike in my case?!)

Let me reiterate - I don't really have a fear of using knives normally now, I have a fear of some really extreme, horrible scenario. So, have I already 'faced my fear' and (almost) won by learning to use knives normally again, and that's enough? Or do I really need to face the most appalling nightmarish scenario to truly 'face my fear', even though I know it is not something I would ever want to do, and that would not occur, in the normal course of life, and that makes me really miserable, when I feel I am so close to being able to let go and be happy?

The only thing keeping my anxiety around this alive is this. I feel I could cast it off completely and get on with life if only I could 'give myself permission to' - if I knew for sure whether it as OK to let it go now, because I have done what is required to get back to functioning normally and I don't need to go further to 'face my fear'. I don't want to feel invincible, and surely it's only human to have a few things that make you feel a little bit anxious (as long as it doesn't significantly impinge on your life) anyway?

Does that make sense? What do you think?

[Bill]

I was under a lot of stress and started feeling down.
I had a horrible thought about whether I could harm myself with a knife. It was utterly abhorrent to me - I know deep down inside me that is one of the worst things I could imagine, it is nothing like me, and nothing I would ever want to do. But it scared me so much.
I really have to 'face my fear', and that this would involve holding one against my skin, because that approximates to my worst fear.

From what you've said, it appears that you were under alot of stress which made you feel very low. This then triggered the thought of harming yourself with a knife but this thought really scared you so that now it's left imprint that you're not sure how to deal with.

You've heard of CBT therapies whereby the therapy is to confront your fear which has made you think that you need to hold a knife close to your skin....but is it necessary when it seems such n extreme measure to take.

Imagine this....supposing at your stressful time you had the thought of going to the North Pole, standing in the frozen wasteland and freezing to death. Supposing then that this thought really frightened you so that every time you looked at a picture of ice or saw snow scenes on TV, this frightening thought would re-surface. Therefore, to confront the fear, would it then mean going to the North Pole and sitting there so that the thought never troubled you again?

Well, if you did, you wouldn't survive so then confronting your fear in such a way wouldn't realy be of any help. It's exactly the same with the frightening thought of knives.

So.....what should you do? Well, we need to use knives every day. They can't be avoided and nor can your frightening thought.

It feels like you "might" have an obsession followed by a compulsion? An obsession because you can't let go of the thought due to the fear it creates and a compulsion because you feel you "have" to confront the fear to remove the frightening thought? I'm ONLY guessing though. It just seems like that.

I feel I could cast it off completely and get on with life if only I could 'give myself permission to' - if I knew for sure whether it as OK to let it go now, because I have done what is required to get back to functioning normally and I don't need to go further to 'face my fear'.

As you say, your rational side says to "let it go" but your anxiety is telling you not to. What I would suggest is in 2 steps - Firstly, when you get the thought about harming yourself with a knife, just "allow" yourself to think it but tell yourself it's "just a silly thought" and to ignore it. Secondly, if you get the thought of needing to confront your fear, rationalise it with what I've said about the North Pole.

I feel what you may actually be doing is looking for a way to relieve the anxiety this thought is creating and therefore you're thinking that if you confront the fear, the anxiety will ease. However, what you're actually doing is fuelling your anxiety because you're looking for a way for "immediate relief" just as someone would with OCD.

What I'd suggest is try to "Allow" yourself to think the thought about knives But "Resist" the thought of trying to find a way to ease the anxiety the thought invokes.

If you think the thought, remember it's Just a thought and Nothing to be frightened of and so there's Nothing you need do about it. Just "let it go" like any other thought and you Will be fine.

I wouldn't want to mislead you in Any way as this is just my opinion as a "fellow sufferer". It's my best guess so I "hope" it helps.
I've had another thought today which I've decided to type as a new post directly following this reply...

[Bill]

.........following on from my post above, I had a thought today which might explain things better for you Orchid...

When someone has a dog phobia, they will use CBT to "gradually" help them to move close to a dog until they can actually hold one to prove not all dogs are dangerous and in this way the sufferers fear is removed by gaining confidence in themselves.

Now imagine, someone being afraid of cars. The same approach could be used until they're able to move close to a car and actually drive it through removing their fear by building confidence just as you would with a dog phobia.

However, what if this new driver then had a frightening thought about running someone over? How would they overcome this fear? Would you then use CBT by telling them to drive up to a person and stopping just as they touch them with the bumper? No, of course not.

You see the similarity though with your frightening thought regarding knives?

If you had a knife phobia, you could use CBT to show that there is actually nothing to be afraid of if the knife is handled carefully. However, your fear isn't related to holding a knife, it's about what your fear is telling you what you "could" do with it when of course you wouldn't. If someone was standing in front of you whilst you were holding a knife, you could have exactly the same frightening thought about harming them instead but it would be just a frightening thought created by your anxiety. You wouldn't "touch" them with the knife to prove to yourself you wouldn't harm them or to remove the anxious feelings you experience whilst thinking it.

When we experience a period of extreme stress, what sometimes happens is that it can cause us a "fear of losing control". What I "think" may have happened is that you had this thought about harming yourself because of the stress you were suffering because it was a symptom of a subconscious fear of losing control due to the stress.

One other thought is that sometimes when we feel very anxious, the feelings can be so frightening that we just want them to stop "immediately" which is why sometimes we look for reassurance or perform or repeat a ritual to cancel out frightening thoughts. The problem with this behaviour though is that the anxiety is never actually dealt with because we create "peaks of anxiety" interspersed with "troughs of relief". We never allow ourselves time to prove that there is nothing to fear.

What we should do is allow ourselves to "feel the fear" because in time these anxious feelings Always "gradually" subside and only then does the cycle stop.

This is what I was saying about your frightening thought. I don't really see how CBT could work because it's an "irrational thought" created by stress. I feel that perhaps it's really a fear of losing control. I also still feel that by trying to perform an act to remove this fear would really be fuelling the anxiety. I feel the best approach is to try and "forget" the thought and Not focus on it. Let it go through you because in time the anxiety associated with the thought Will gradually subside.

Hope that's of some help.

[orchid]

Bill,

Thanks so much for this, you really seem to understand my situation. Sorry I've only just received it, I've not been on the site for a few days as I've been concentrating on living(!) but I got the emails about the changes to the site and ended up logging in and catching up on things.

I really think and hope your advice is right. It makes sense to me and is along the lines of what I have always thought was right, but I got so sidetracked with other bits of advice I picked up here and there until I got totally confused and scared. There is so much conflicting (or seemingly conflicting) advice out there regarding stress, anxiety, OCD etc and some people are so dogmatic about what they believe does and doesn't work (sufferers and therapists alike!) that is so difficult to know what to believe, especially when you are prone to believing the worst!

In a short period of time I went from feeling genuine and understandable stress related to work to fearing that I had some really serious mental health problem that would only be fixed by extreme therapy, mainly from what I read on the internet, in self-help books etc! I guess when you're stressed or anxious you are more likely to catastrophise, not see the wood for the trees and be influenced by what you read. Telling someone in a delicate state to 'face their fears' without explaining what that means seems really unhelpful - if they're anything like me they'll just imagine something extreme and then depress themselves with the idea that to stop felling anxious they'll have to face it... when really they should just let it go.

My old strategy was 'if you get a scary thought, let it come and go, but there's no need to go looking for them or ruminating on them'. This worked really well, until I started reading about 'hunting for spikes' and 'facing your fears', and I started thinking, 'well, if you don't do that it means you're avoiding it', and then off I went down and really miserable spiral again.

I guess we really have to trust ourselves, be discriminating about what helps us and hinders us, and not beat ourselves for 'not doing it properly' when what we're doing is working!

I know what does work for me and what makes things worse and I should trust in that, follow my instincts, and not listen to my doubts. I think that's great advice for anyone suffering with anxiety. When we're clear headed we often just know what's right but when we're stressed we 'go off on one' and start imagining and believing all sorts of nonsense. We should not try to 'solve' things when we're stressed but recognise that that's how we are just now and look after ourselves until we feel better. Then we'll able to see that either there's nothing to worry about, or see clearly how to deal with any real issues there may be.

[orchid]

Hi there,

Well, I've got a case of the 'night nadgers' - woke up and now have a nagging question in my head, so I thought I'd get it out on here so I can forget it and go back to sleep for a bit!

Bill, or anyone else, can you answer it for me?

It's back to this idea of extreme therapy again. I know that some therapists do use it on patients, and the examples that I've heard of that bother me the most are getting someone with a fear of harming their child to put their hands round his neck and someone with a fear of harming themselves to hold a knife to their wrist.

These things just seem so utterly abhorrent to me. I know I would never want to hurt myself or anyone else and I would never put myself in those sorts of scenarios in normal life, but I'm worried that because these thoughts scare me, I should have to face them by deliberately putting myself in those positions. This thought depresses and upsets me so much.

Bill, you have already tried to answer this for me, but I still can't quite understand it. So my question now is, are the therapists who do that sort of therapy wrong to use it? Or is it just that I only know half the story and it might have helped those people (e.g. because they thought they would do something awful and that showed them they wouldn't) but it wouldn't help me (because my problem is not that I think I'll do something awful but that I would have to undergo this sort of extreme therapy because it scares me) ?

Is it just my anxiety making me bark up the wrong tree on this? It's just the fact that I know this therapy exists keeps nagging at me when I try to ignore it. Should I just realise that it's just anxiety bugging me and continue to ingore it? Is that the right course of action for me?

Does that make sense?