Free Yourself from Anxiety (2 page)

This book is intended for people affected by all forms of Anxiety: phobias (including agoraphobia and social phobia), obsessive compulsive disorder, panic attacks and generalised anxiety disorder. We do not recommend using this book if you suffer from post-traumatic stress disorder or for anxiety problems in young people and children.

Emma and Martha would like to thank: The Group, for the time they gave to this project; Angela, Chris and Isabelle for their feedback on the text; First Steps to Freedom, and No Panic.

Emma and Martha dedicate this book to all the volunteers who give their time to helping people with Anxiety.

The black hole of anxiety

For most people, anxiety seems to come from nowhere and hit them like a sledgehammer. One minute, more or less happily living your life, the next, terrified and distraught, struggling to breathe perhaps, convinced you are dying, or that someone else will die and it will all be your fault.

Maybe you visit your doctor straight away, maybe you struggle on alone for as long as you can, but sooner or later you will be told that it’s Anxiety. Just anxiety.

This doesn’t make any sense. You know what anxiety is. It’s glancing at the clock and wondering uneasily why someone is late. It’s double checking that you put the handbrake on when parking on a hill. It’s not this living nightmare that turns every minute of every day into a torment of worrying.

Except that it is. Your normal anxiety has got out of control and turned into an Anxiety Disorder. In other words, everybody has some anxiety, but not everybody has Anxiety. In this book, when we give anxiety a capital ‘A’ we are talking about an illness, and you can recover from it. There is good help available on the NHS, but it can mean a long wait as your name works its way up the list. If you are housebound, the wait for a visiting therapist is likely to be even longer. Why not try to help yourself in the meantime?

Some people are able to stage a full recovery through self-help. Others may still need help from a professional to finish their work, but they will
go into the sessions armed with self-knowledge and an improved understanding of their illness.

Anxiety is a black hole. It sucks in your hopes, your pleasures, your plans for the future and above all your energy. It’s picky though. It leaves behind fears, worries, and exhaustion. No wonder it’s hard to pick yourself up and find the energy for a recovery programme. No wonder you feel like staying in your safe place and doing as little as possible.

It is possible to turn this round. It is possible to come back from the black hole of Anxiety. The aim of this book is to help you set up and follow a self-help recovery programme. Working at your own pace, in small steps, you can learn to let go of Anxiety and reclaim your life.

Getting equipped

There are two basic things that you need.

A notebook
– you will need to write things down as you work through this book. A notebook is better than a collection of scraps of paper, because sometimes you’ll want to look back and see how far you’ve progressed.

A relaxation tape or CD
– organize this now, before you start work, so that you have it to hand when you need it. You can buy them in any music store, and often in health food shops and chemists. If you are housebound you could ask someone to get it for you, or use the mail order service provided by the charities in this field (see Appendix 2 for their contact details).

Deep relaxation is an important part of recovery from Anxiety. This is not the same as relaxing in front of the TV, or with a book, or anything else you may choose. These are all good for you, but you will also need to learn to do full relaxation. There is more about this in Chapter 6.

You should aim for a recording with a voice on it, rather than just music, and there are two main types:


Progressive muscle relaxation:
the voice talks you through the process of clenching and relaxing every muscle in your body.


Visualisation:
the voice describes a relaxing scene, such as a beautiful garden or a deserted tropical beach.

Choose whichever type appeals to you most. It is okay to buy one of each and decide which you prefer after playing them. If you don’t like the idea of listening to a strange voice, then you can record your own voice, or ask a trusted person to record it for you. See Extra Information 1. I for a script that you can record.

Group members talk

All of the examples in this book are taken from real life, from the stories of people with Anxiety who either told us about their experiences or wrote them down for us. We haven’t changed their words. They all understand the suffering that Anxiety causes. Let’s meet the group:

‘I was on tranquillisers for 36 years and your body becomes tolerant and you start to feel anxiety symptoms which get worse when you stop taking them.’
A
NDREA

‘I had an older brother who was cleverer than me, and I developed a stammer when I was 8 years old which made me very self-conscious.’
A
NDREW

‘I was on the bus going to visit my mother and I started to feel floaty and scared and out-of-sorts. I thought I was going to have a heart attack. I wasn’t able to breathe, I felt I was losing my breath.’
B
RIDGET

‘…my mother has told me I was an unsettled baby and I think I was quite an anxious child. I never felt safe, perhaps because of a traumatic experience when I was 4 years old.’
J
ULIE

‘to my horror [I] overheard someone say that… my dad had died… I don’t remember questioning my mother as to the truth…my mother seemed distant from me… unfortunately, her inability to alleviate my sorrow had a profound effect on me.’
M
ARGARET
H
AWKINS,
C
HAIRPERSON OF
N
O
P
ANIC

‘I hear people say they feel as if some power from somewhere has cursed them with this strange madness for life, and that no one else in the world has this problem.’
N
ORMAN

‘I had two upsetting events as a young child, when an older boy exposed himself to me and I ran all the way home and then when I was 6, I had my tonsils out in hospital. They gave you a ride on a rocking horse and when you turned round your mum had gone … just like that! In those days parents weren’t allowed to visit, a whole week with no contact!’
P
EN

‘I had a traumatic experience when I was about 13 – I was raped … Now, I have flashbacks, like a video in my head. Feel anxious all the time. I am still extremely scared to go to places associated with where it happened.’
S
ARAH

‘School was terrifying, I was so self-conscious. I took a lot of time off. I thought I was weird, not normal.’
T
ERESA

‘My first experience of anxiety was when I was 13, in the 1950s. I was going into school assembly and I just wanted to come out, I felt I’d pass out any minute. I was very hot and we were stood there for 20 minutes or more.’
W
ENDY

We are very grateful to them all for being willing to share their stories. You will learn that they’re in various stages of recovery. Several of them are volunteers with charities such as No Panic and First Steps to Freedom. The full version of Margaret’s story is available from No Panic, see Appendix 2 for contact details.

Ways of using this book

You may feel ready to undertake the challenge of working towards a full recovery. You may feel interested in the idea, but nervous about it. Or you may feel a deep resistance to it. Whatever your current feeling is about recovery, whether you feel optimistic, pessimistic or somewhere in between, you can use this book to make a start.

You can use the ideas and exercises in whatever way suits you best at the present time, and you can come back to them at a later date when you are ready for more progress. There are four particular ways in which this book can help:

1. Relief from the worst aspects of Anxiety and managing your present life better.
You’ll acquire a set of simple tools that will help you to feel better, more in control of your life and more confident. By learning to relax, taking more exercise, eating and drinking more sensibly, learning not to fear panic attacks, practising self-exposure and turning negative thoughts to positive, you’ll feel more able to cope with your life as it is now.

2. Recovering from your current bout of Anxiety
There are a lot of different techniques explained in this book. As you work through them you’ll build a complete portfolio for Anxiety management. Not all of them will work for everybody, but the only way to find out is to try each one. You’ll then be able to create your own individual recovery programme.

3. Dealing with problems in the future
Even when you are over the worst, setbacks can occur. Life will continue to present challenges. If you are prepared for them, they won’t overwhelm you or send you hurrying back to your safe retreat. Once you have worked through this book you will have the skills you need to prevent relapses. You’ll be able to recognise the early warning signs of Anxiety, and you’ll know which techniques work best for you so that you deal with it before it takes hold. And if you do experience a setback, you can review the situation and ask yourself what you can learn from it and how you could have done things differently. This is more than first aid – these are tools for life, and a life which is less Anxiety-prone.

4. 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. You can choose how far down the road you travel. If you are satisfied with levels 1, 2 or 3 then that’s fine. The important thing is that you can make your own choices about important areas in your life – this is a truly healthy state. When Anxiety rules your life, you feel trapped or bullied by it, but when you work through this book you’ll start to take back control.

Exercise

In your notebook, make two lists, headed ‘things I have to do’ and ‘things I can’t do.’ Include the things that Anxiety makes you do, or stops you doing, and anything else that you feel you must do or can’t do. Here’s a brief example:

I have to stay at home

I have to cook for the family

I can’t go in the garden

I can’t control my dog

Now rewrite each list. Instead of ‘have to’ write ‘choose to’. Instead of ‘can’t’ write ‘choose not to’.

I choose to stay at home

I choose to cook for the family

I choose not to go in the garden

I choose not to control my dog

Suddenly you can see that you to have more choice than you thought. This can be a powerful turning point – and remember, it includes the choice
not
to change. If you have truly weighed up the pros and cons, the gains and losses, you may decide it’s okay to settle for level one, or two, or three.

GROUP MEMBERS TALK

‘I have general anxiety due to withdrawal from tranquillisers.’
A
NDREA

‘I have suffered from OCD most of my life.’
A
NDREW

‘In the end my diagnosis was panic attack.’
B
RIDGET

‘I’ve had panic, agoraphobia, death phobia, social phobia, illness phobia and claustrophobia.’
J
ULIE

‘[I] could not shake off the feelings of dread … I was constantly in a state of fear.’
M
ARGARET

‘My very first recollection of any symptoms resembling that of obsessive-compulsive disorder began to reveal themselves to me as a child.’
N
ORMAN

‘I have agoraphobia and GAD.’
P
EN

‘I have Borderline Personality Disorder and chronic Post-traumatic Stress Disorder.’
S
ARAH

‘From what I know today I reckon I had social phobia.’
T
ERESA

‘I’m a recovering agoraphobic.’
W
ENDY
  

A person having their first panic attack can think they’re having a heart attack. Someone calls an ambulance, they are taken to Accident and Emergency, and after the usual tests they are told that it’s panic. The most common reactions to this news are embarrassment and disbelief, but at least they’ve been seen by a doctor and can start the process of coming to terms with what has happened to them.

At the other end of the scale, some people live with their illness for years without having it properly diagnosed, without talking to anyone about it and without getting any help.

Seeing the doctor

Quite simply, everyone needs to see a doctor to discuss their symptoms and get a diagnosis. There are a few physical illnesses whose symptoms are just like Anxiety so you need to make sure that you’re not suffering from one of those. There is no point in reading this book and doing the work we suggest if, for instance, you are suffering from a thyroid problem that can be treated by tablets.

So if you haven’t seen your doctor yet, now is the time to do so. If you are nervous about doing this, consider taking someone sympathetic along with you for support. If you are housebound, ask for a home visit.

The important thing to remember is, that if it turns out you do have an Anxiety disorder, it is an illness and it is not your fault, so you really don’t need to be embarrassed.

Sometimes people worry that their medical records will always show that they’ve had a problem, and this will go against them in some way. And yet these problems are extremely common, so there must be thousands of people with similar records who are now leading happy and fulfilled lives. Wouldn’t you like to be one of them?

What will the doctor do?

You can expect the doctor to listen to what you have to say, and ask you a few questions. He or she will probably do a few simple checks to rule out a physical cause. If a blood test is suggested and needles are a problem for you, then say so. Even if the blood test has to wait for another visit, you will have made your first steps towards recovery.

How shall I talk to the doctor?

Sometimes people worry about how they are going to explain what they are feeling. It might help to make a list beforehand of all the sensations you experience. If you need to talk about one incident, then don’t talk too much about the build-up to it. A simple statement will get the conversation started and the doctor can ask you questions to get more information.

‘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 wouldn’t hold me.’

If you need to describe a continuous feeling, again keep it simple:

‘I feel so shaky every morning that I just can’t 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. It can take me all morning to get past it.’

Remember these remarks are just to get you started. You may not yet feel able to ask the questions that really haunt you: Am I going mad? Will my heart stop beating? Never mind. You’ve made a start.

And while we’re on the subject, let’s answer those two questions. A person with Anxiety is not going mad, and neither Anxiety nor panic will make anyone’s heart stop beating.

What will happen next?

There are various things the doctor can suggest to help you:


Let’s wait and see:
if your Anxiety is very new, it can be a sensible idea to wait a couple of weeks to see if it subsides. If that is suggested, use the time to give yourself some TLC and to make the changes we suggest in Part One.


A short course of tranquillisers:
although doctors now understand that tranquillisers are addictive if used for too long, taking them for a short time can help someone over a difficult patch.


Other medication:
you may be asked to try beta-blockers or antidepressants. Sometimes you may need to try more than one antidepressant to find the right one for you.


Counselling:
many surgeries have a counsellor who can talk to patients. Expect to have to wait for an appointment.


A mental health nurse:
some practices have a Community Psychiatric Nurse (or CPN) who can work with patients.


Referral to a mental health unit:
your doctor may offer to refer you to a hospital consultant, but waiting lists can be very long.

Did it worry you when you saw the words ‘mental health’? Anxiety is a mental health problem, but mental health is a term that covers a huge range of issues and only a few of them are long-term permanent problems.

If you are offered therapy, one of the most common approaches is called cognitive behaviour therapy. It is very successful in helping people with Anxiety and this book is based on its techniques, so you will learn more about it as you work through the book.

GROUP MEMBERS TALK ABOUT DIAGNOSIS

‘I was diagnosed by my GP.’
A
NDREA

‘[I] was diagnosed by a doctor in my early 20s.’
A
NDREW

‘I was near my GP so I went there and he saw me straight away, he did a few tests and then sent me to hospital, he thought it was panic but he wanted to be sure.’
B
RIDGET

‘I was diagnosed by doctors, but I had a problem accepting that it was anxiety and not a physical health problem.’
J
ULIE

‘I must have been in the surgery with my GP for at least half an hour. He proceeded to explain to me that I had developed what was then called obsessional-compulsive neurosis.’
N
ORMAN

‘My first diagnosis was neurasthenia, the word agoraphobia was used much later. A doctor said to me “it’s like there are too many packs of peas in the freezer, and the lid won’t close it goes into melt down.”

P
EN

‘I was diagnosed at my first hospital admission, age 16. I was diagnosed with PTSD quickly but not much was done about it.’
S
ARAH

‘The doctor diagnosed depression. I think he prescribed Librium.’
T
ERESA

‘Our doctor was ahead of the times, he gave me some tablets but he also sent me to our vicar, who was a counsellor working at the surgery, and he gave me the diagnosis.’
W
ENDY

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