Mary Mcilroy Counsellor in London Bridge,
the City of London & Muswell Hill

Coping with Anxiety. panic

How to Control a Panic Attack

Panic attacks often happen as a result of certain situations such as:

Having to address a group of people, fear of speaking to the opposite sex, dilemmas we can’t control. They can manifest as:
an increased heart rate, difficulty breathing, irrational thoughts, feeling we are going mad / dying. Often our answer is to avoid the situations were the panic attack is triggered. This answer can lead to isolation, social anxiety and agoraphobia.

The physical symptoms are a result of emotions being unconsciously repressed and physically somatized. A common reaction is to believe ’there is something physically wrong with me’. A Panic Attack is a psycho-physiological (mind-body) response to unresolved emotional needs.

Steps to help overcome Panic Attacks are:

Acceptance. Accept the reality. In the moment you have to accept this is happening but it will pass.
Roll with the punches. Don’t deny your emotions.
Picture a surfer on a wave, the panic attack will swell and it will subside.
Tell people. If there is someone you trust nearby it will help calm you simply letting them know.
Learn a relaxation technique, relaxation and panic are incompatible.

If your Panic Attacks become severe it is imperative to resolve the underlying issue.

If you are alive you’ve got stress, ongoing irrational stress and anxiety can have damaging effects on your body.





Coping with Anxiety. Aspiration

Anxiety and Ambition

When the goals that propel us forward are thwarted, it's easy to give up. If we try, there is a risk of failing, mediocrity, or not reaching the benchmark we set for ourselves. We can give it our best shot and still not make the money, gold, recognition of our peers, or our fathers approval. The reward could be humiliation despite our utmost effort.

If you can:

Clarify your goals, eliminate your doubts and pump up your own determination.
Speak to the nagging, angst-laden voice inside.
Then ask yourself “where and when have I experienced success”?
Relive the experience, what’s the image?
Hold onto that image. Is your anxiety fading yet?
Reducing anxiety allows our innate desire for fulfilment to kick in and function while lifting our spirits.
Hey-ho, we can turn to excelling again and reach our potential as far as possible.





Coping with Anxiety. health

How Anxiety Affects Physical Health?

While it is natural for the pressure of the day to day live to leave us stressed or worried at times, some people experience a continuous feeling of anxiety, even in the absence of the need to fight or flee. They live in a constant and unjustified fear or distress that can impact greatly on their daily lives. Such excessive and on-going worrying can in fact affect your body and lead to a physical illness.

Research suggests that anxiety sufferers are at greater risk of developing certain medical conditions. Although there is an on-going dispute within the field of therapy, focused on ‘which comes first’, i.e whether a prolonged physical illness can lead to anxiety, or whether medical conditions can be developed as a result of excessive worrying.

Regardless of a chosen approach, one thing is certain; anxiety is strongly linked to some chronic medical conditions, like:

- Thyroid disease (hyperthyroidism)
This medical condition may present itself as an anxiety syndrome, as it can significantly affect your mood. Research show that the more severe the thyroid disease, the more erratic your mood can be. Those suffering from hyperthyroidism may experience unexplained nervousness, restlessness or irrabillity.

- Heart disease
Research show that people who suffer from chronic heart disease have increased chances of anxiety disorders. Similarly, those with heart arrhythmias have an increased prevalence of anxiety disorders.

- Gastrointestinal conditions
Digestive problems are extremely common among those who suffer from anxiety. The changes that impact on our digestion do not start in our stomach, but they start in our brains. A number of studies highlights that ‘gut-brain connection’. Our gastrointestinal tract is very receptive to our emotions. Strong feelings like anger, sadness or anxiety have a power of triggering reactions in the gut.

- Chronic respiratory disorders
Respiratory problems can be linked to anxiety. Very often there is nothing medically wrong with the patient’s lungs or heart, but they experience a strong sensation that makes them think that they suffer from respiratory problems. Anxiety can have a direct impact on our breathing patterns. It can activate the fight or flight system which pumps adrenaline into the blood stream. Consequently, our breathing becomes faster. Anxiety can also lead to hyperventilation, also known as ‘over-breathing’.

Therapy is an effective way of overcoming anxiety disorders. Unlike medications, it treats more than just the symptoms of the problem. It can help you to uncover the underlying causes of your stress and fears, teach you how to relax, change your outlook on life in general and develop practical, coping techniques that will allow you to handle your emotions in a better way.



Coping with Anxiety. anxiety a

Supporting a loved one with anxiety


Almost all of us experience nervousness or a sense of sadness from time to time. Anxiety is in fact a natural and important part of our system, it serves to enhance vigilance and increase motivation. However, ongoing ‘chronic’ anxiety can be harmful if not attended to. Those who suffer from it on a daily basis find themselves unable to deal with stress, learn or make decisions.

As hard as anxiety is for the sufferer it is almost equally as painful for their family and friends. If someone close to you is struggling with anxiety you may feel confused, tense and distraught yourself. Maybe you have found yourself walking on eggshells because you are constantly afraid of causing even more upset. Or maybe the stress, tension and the feeling of being stuck have caused you to disengage from the relationship altogether? Keep in mind that your support is crucial and there are steps you can take to help them feel better.

Educate yourself - Gaining more understanding about anxiety and its symptoms, causes and treatments can be a great starting point. This will help you better understand what your loved one is going through. It will also assist you in identifying for yourself the best ways of coping with it.

Become an active listener – instead of trying to suggest solutions or advise, the best approach may be offering some neutral responses such as “I can see how that would upset you..”, and let the other person feel heard and supported.

Don’t judge – help them recognise that they can talk about their feelings openly, without any fear of judgment.

Set boundaries – your loved one may continue to ask for accommodations such as having you drive them to places, staying at home with them or wanting to talk to you frequently on the phone while you are at work. While it is vital to provide them with as much comfort as you can to limit their feelings of being lost and alone, you should also remember that you can do things independently. When responding to such requests remain loving and empathetic, but at the same time make an effort to protect your boundaries. Sometimes helping can be stopping helping.

Get active outdoors together - try to spend more time outdoors being active. Regular exercise is a well- known remedy for anxiety, as well as a great way of soothing built-up angst, nervousness and low mood.



Coping with Anxiety. Eating disorders and anxiety

ANXIETY IN EATING DISORDERS

Most people find something about their body that they would like to change or improve and those who approach it in a healthy way opt for more exercise or a better diet.

Unfortunately some of us aim for improved body image in a rather destructive way. Those suffering from eating disorders do it through inflicting a great deal of harm to their bodies and minds which can have life-threatening or even fatal consequences.

Most patients with eating disorders will also encounter a level of anxiety at some point in their lives. A 2004 study reported in the American Journal of Psychiatry which examined the relationship between anxiety and eating disorders found, that approximately 42 percent of examined respondents developed an anxiety disorder during childhood, long before their eating disorder symptoms occurred.

This common link between anxiety and eating disorders emerges from the negative feelings of low self-esteem, fear of criticism and lack of trust in other people that are core to both conditions.
Also, in cases where anxiety precedes an eating disorder, ability to ‘control’ the aspect of one’s life such as food and weight provides the sufferer with a false sense of control. Such false feeling of being in control can temporarily relieve anxiety symptoms i.e. the purging effects of bulimia have shown to both physiologically and psychologically have a calming effect.

What has been also observed is that anxiety sufferers tend to feel safest when they are alone, far away from potential judgment or criticism of others (whether perceived or factual).

It is crucial to treat anxiety and an eating disorder simultaneously as the two are closely related and common issues are addressed to heal the underlying factors associated with both disorders.

Psychotherapy can be an effective way of achieving this due to its comprehensive character. It can help in learning healthier coping mechanisms for managing both, anxiety and eating disorders. It also allows the creation of a supportive space where the patient can identify, understand, change his thinking and as a result his behavioral patterns.



Coping with Anxiety. anxiety relationships

How anxiety affects personal relationships


We live in times where our body image seems to be of more importance than our mental wellbeing. We are surrounded by magazines and television programs promoting the importance of physical fitness, while crucially the subject of mental health is often ignored.

The risk here lies in the possibility of overlooking important symptoms of a mental disorder and assuming they are caused simply by stress or bad mood. Unfortunately, over time, unnoticed conditions tend to worsen and gradually take toll on our relationships. Anxiety, in particular, can impact on our personal relationships in a number of ways, here are some examples:

Worry and suspicion
The worry that usually comes with anxiety is often unsubstantiated, nevertheless sufferers cannot stop themselves from thinking that way. This can affect a relationship in a number of ways i.e. it can lead to jealousy or suspicion, where although you know that your partner loves you, but may continue to wonder what would happen if he or she were not faithful. Such thoughts can easily lead to arguments and unnecessary ‘interrogations’ with both sides feeling frustrated and angry.

Limited patience
Impatience often goes hand in hand with anxiety, affecting the person’s mental state and making them search for ‘immediate’ solutions in stressful situations. Sufferers often struggle to maintain the harmony in their relationships, especially when it comes to finding the life- work balance.

An extensive need for reassurance
With increased worry in their day-to-day life, anxiety sufferers tend to require constant reassurance from loved ones, asking for more attention and more time together. This may make people feel burdened, as a physical and an emotional space is a basic human need. Such intense expectations are very likely to lead to a disappointment and ultimately a failure of the relationship.

Magnified reactions
Anxiety sufferers often find themselves in situations whereby their general sense of insecurity, coupled with temper issues, can take over their usual ‘self’ and lead to overreaction and anger. This can make them feel out of control and so overwhelmed by powerful emotions that they react in the heat of the moment, not thinking of the destructive consequences it can have on relationships.
The partner at the receiving end, who may not be aware of the existence of a mental disorder, may simply feel too hurt to forgive and forget.

Observing yet ignoring the above symptoms usually leads to a gradual breakdown of the relationship. Understanding the condition and receiving support from friends and loved ones is absolutely crucial for the recovery of the person with an anxiety disorder.



Coping with Anxiety. 4 ways for reducing anxiety

FOUR EFFECTIVE WAYS FOR REDUCING ANXIETY

Living with anxiety is never easy. It can be truly overwhelming for sufferers and millions of people struggle with anxiety on daily basis. This is why it is very helpful to learn ways of finding some relief. While anxiety cannot be cured over night, there are some useful techniques that can be integrated into your daily life to calm yourself down in times of crisis. Here are four anxiety reduction tips that you may find helpful:

1.Control your breathing

Think about your breathing every time you get anxious. Shallow breath contributes to panic. More controlled, deep breathing on the other hand, is a powerful anxiety-reducing technique because it activates the body’s relaxation response. Slow down your breathing and take a deep, but gentle breath through your nose, trying to hold your breath for about three to four seconds. Breath out slowly through pursed lips as if you were whistling.

2. Accept and embrace the feeling of anxiety

Simply accepting that you are feeling anxious is critical to controlling your feelings. Trying to eliminate the feeling of anxiety on the other hand, often worsen its symptoms.

3. Perform some simple aerobic routine

When you feeling anxious exercising can make a big difference. This is because it offers a number of advantages for controlling anxiety symptoms i.e:

- release endorphins which improve overall mood

- burn away stress hormones

- force healthier breathing

- offer a healthy ‘distraction’

4. Talk to a friend

Make contact with someone that you can trust, even if it is only over the phone. Talking through and explaining your feelings to someone who knows you well can bring a lot of relief and will have a calming effect.

There are no instant magic cures when it comes to overcoming anxiety however, learning some calming strategies, and most importantly, implementing them into your daily life can greatly improve your long-term outlook.



Coping with Anxiety. what causes anxiety

WHAT CAUSES ANXIETY?

As with many mental health conditions, the exact cause of anxiety disorders isn't fully understood. Studies show that anxiety often develops for no apparent reason.

However, there are some common external factors that can cause the condition:

Inherited traits- to be précised your genetic makeup. Recent studies show that the risk of anxiety tends to run in families, but the role of genetic influence versus the influence of the family environment remains unclear.

Personality traits – studies suggest that people with certain personality traits are more likely to develop anxiety disorder. This applies in particular to children who strive for perfection, who are easily agitated and those who want to control everything.

Major Stress or Trauma – here events such as abuse, the death of a loved one ore victimization can trigger the condition. Childhood traumas in particular may make one more prone to anxiety in later life.

Substance abuse – there is a strong link between anxiety and excessive use of drugs and alcohol. Anxiety sufferers may begin using medications to manage symptoms of anxiety, while those who are substance abusers are very likely to develop anxiety disorder as a result of their addiction.

It is often a combination of factors that contributes to a person suffering from anxiety. The most important thing is to recognize the signs of the condition and seek professional help. The sooner you get help, the sooner you can recover.



Coping with Anxiety. Angst

3am Angst and Aloness


In the day I’m busy.
At night I wake at 3am feeling anxious, desolate, powerless, empty.
In the night I get lonely and want to reach out but who is there to respond to that tender place needing comfort and soothing, to help me get away from the lonely tenderness of the night?

Now it's night and there is no getting away from the doing -----,
Now there is a need for intimate contact and the sharing of matters of the heart, for someone to share softer emotions with as:

The alleviation of aloneness (and lessening of our angst) is the sharing of that aloneness. It cannot be eradicated, we are all separate, it is the human condition, a perceptual physical gap. The gap between you and I is full of intense aloneness but the sharing of that aloneness states at the spiritual level

We are one.

So when you fall prey to your internal attackers beating you with the imperative ‘you shall know no rest then challenge your internal dialogue, allow yourself to look at things differently. Why are you denying yourself peace? Maybe if you give yourself the freedom to look at your busy hours differently you might relax at 3am. Some suggestions for 3am peace are:

Avoid stressful topics, learn what your triggers are. Can you identify your stresses, try keeping a diary to help find the patterns behind your stress.

Welcome humor, watch a funny movie before bed.

Don’t eat late, avoid too much coffee and alcohol.

Remember to use the skills you use for daytime anxiety.

Self-soothe, there are many forms, yoga, meditation, a massage, a hot bath....

Daily exercise can help.

Practice a breathing meditation, count slowly to 10, if necessary count to 20.

Do your best, don’t aim for perfection, be proud of how close you get.

Accept you can’t control everything, put the situation in perspective ‘is it as bad as you really think?

Reframe your negative thoughts.

Talk to someone, tell your friends and family you are overwhelmed. Let them know how they can help you.

Talk to your GP or Therapist.



Coping with Anxiety. Ease anxiety

3 Ways to embrace anxiety


Your throat is tightening, heart races, your back feels tense and you may had few sleepless nights. That familiar feeling creeps in. Anxiety.

Our natural reaction is to get away as far as possible from this feeling- which often results in drinking too much, frequent visits to the fridge or simply avoidance and wasting hours of your time aimlessly surfing the internet.

But how about if instead of trying to suppress anxiety we could simply welcome and befriend it, when it shows up?
According to famous, Danish philosopher Soren Kierkegaard anxiety is a very natural condition. Soren believed that anxiety was a feeling that in fact powers creativity instead of sabotaging it. He described anxiety as a liberating possibility that should be embraced rather than suppressed. In his own words “ One would have no anxiety if there were no possibility whatever”.

Wouldn’t it be liberating if we could share this attitude towards anxiety, accepting it as a natural component of our every day lives? Let’s look at three inspiring ways for turning anxiety into power:

1. Accept the reality- face the feeling of anxiety and admit that you are feeling anxious. Anxiety is just a feeling, like any other. Realizing that you are simply undergoing an emotional reaction makes it easier for you to accept it. Once you accept and become more comfortable with this feeling you can eliminate thoughts that worsen it.

2. Question your thoughts- challenge the thought process that is running through your mind. When we get anxious, we tend to develop most gloomy scenarios that are very unlikely to occur in reality. Perhaps you are paralysed by the thought of delivering a presentation or giving a speech at a family gathering. Ask yourself few useful questions, i.e. is my worry realistic, what’s the worse situation that may happen, how likely is it to happen and what I may do to prepare myself for such situation.

3. Reframe anxiety as excitement- public speaking, going through exams, attending a job interview or performing in front of people, all these situations can fill us with anxiety. But instead of trying to suppress the feeling and forcing yourself to calm down, allow yourself to get excited. Anxiety can be very debilitating when it leads to inaction. To avoid, that, focus on possibility, visualize the success and how you feel once the ‘testing time’ is over. Turning your anxiety into excitement will help you to become a more persuasive and competent performer.

The more time you spend on clarifying your feelings and emotions ‘here and now’ the calmer you will become. You learn to remind yourself that this is ‘just anxiety’, and while it may not be ideal, it is certainly not intolerable.



Coping with Anxiety. Anxiety issues

How not to deal with anxiety- the sound of silence


Aagh my mind is racing with nowhere to go. I feel there’s a lot I haven’t done yet today (I didn’t go to the gym for one). Does this mean I’m being lazy? The silence is deafening, I haven’t spoken to anyone for hours and that feels wrong too. Should I play baroque music to relax or catch up with new sounds? I finished a book last week and still haven’t found a new one. Maybe I should be reading cutting edge stuff on what I don’t know about? I’m finding it hard to cope with nothing to do.

This peace and silence is too slow a pace, it feels wrong. There must be something I need to do to fill my free time and empty space. Maybe if I meditate the missing 'something' will come to me. My mind feels like a time bomb but my body feels like a statue….

However, I’m actually wide- awake now, feeling energetic and without distractions. Hold on, maybe I’m beginning to integrate mind and body. Even my breathing is unusually calm. Wow, is it the meditation? I just might achieve a balance here. I’m becoming aware of my thoughts now:

To avoid anxiety we need to slow down first, then we become aware of our feelings, a feeling of relaxation (maybe this is the ‘Mindfulness ‘Pause’). Hmm a nice slow exhalation next, a deep sigh, a gentle breathe. I’m managing to keep calm without even trying. Now a thought –‘less is more’ -if I do less, I will feel more relaxed. If I pay attention to what I do have and not stress about what I don’t have I will enjoy quality time rather than quantity of stuff………

Part of me want to race ahead, part of me wants to be calm and enjoy here & now
Trust which to follow
Slow down, breathe, be aware of your feelings (feel them), be mindful, think, give yourself the time and space to just be instead of whipping yourself to keep on with the doing.



Coping with Anxiety. Memory Anxiety

How improving memory can combat anxiety (and improve your health)

Memory is not a video camera. As we go along we do not take in everything, we only take in a certain amount: what we were paying attention too. As a child we were interested in everything and noticed much more, as adults we see what we expect to see and what we want to see so we miss out all the peripheral stuff.

Our brain plays tricks on us, it helps us remember childhood stuff really well but we can’t remember last week! Whats happening? What happens is we revisit and revise memories constantly so we think we remember those childhood memories. In reality those memories are Chinese Whispers of what we think we remember. What other people say contaminates what we remember, we might confer with others and even believe we saw or heard what never happened -this is a real problem for police work!

How do we remember how to tie our shoelaces? -practice and practice when learning makes the process totally automatic, we no longer need to remember. How do we remember our pin number? -our fingers remember through practice. What happens if we stop practicing? We return from time away and doubt we know the pin number, now we have ‘Expert Induced Amnesia’, if we have to rethink we panic and set up further memory blocks. Look at England’s football records. We have expert professionals who really know how to score until its penalty time, now the pressure is huge. The player has to score, that automatic easy peasy goal goes over the net, goes wide, the goal is completely missed as he has to think about it.

Remembering is a 3 stage process:

First we need to get it into the brain. Our memory is not a video, it needs to be encoded. If it is not encoded properly the memory will never come back.

Next we need to store it in the right place.

Retrieval if the hypocampus (brain) is damaged its like a drawer that sticks.

The more anxious you are, the more depressed you become and the worse your memory gets. By our mid 30s our brain processing speed declines, we are not quick to take information in. Fortunately, we can cope. Acceptance is key, we can’t make it better but we can work around the nuisance. Here is where counselling works as it can help us reduce the anxiety.

Studies show-----being overweight accounts for 30% of our memory problems. We know it's important to keep fit and healthy but this study adds a new dimension to reasons for keeping fit -it helps look after our brain. Diet and exercise makes a big difference to maximising memory retention.

SOS -Strategies, outsourcing and social support to help improve our memory.

Visualising the scene, counselling can help bring up images.

Processing the task to be remembered more deeply by telling yourself “now I am turning off the iron /locking the door”.

We all know how writing lists /diary /note taking helps get memory system in place.

Ask others “can you remind me” -a poor memory has nothing to do with intelligence.

In this digital age we have apps, even if you are not a computer user you can still learn how to use the app on your mobile. Use the ‘did I turn it off’ app. If you have an iPhone you have ‘apple reminders’ app. You might have a voice activated app.

Go time hopping -place notes and photos in your diary or on social media as a visual reminder. Use a visual schedule planner to help you remember in a visual way if you’re anti-technology, this takes you step-by-step as you tick off.

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