STRESS AND ANXIETY

Understanding Stress & Anxiety

Stress and Anxiety are closely interlinked and influence each other. Both can lead to psychological distress. Stress and anxiety share many of physical and psychological signs making it a bit difficult to find the differences between them. Both can result in poor sleep, lack of concentration, increased irritation, tiredness and excessive worry.

How common are stress and anxiety?

While stress is our body’s response to a threat and often a short term experience, anxiety is a sustained psychological disorder that can significantly interfere with our daily functioning. Stress can be both positive and negative and often fades with time. On the other hand, anxiety doesn’t fade away with time and tends to hand around and can cause significant disruption in social, personal and professional areas.

Anxiety is not an illness that you either have or do not have – EVERYONE HAS FELT ANXIOUS!! In fact, globally, 1 out of 13 suffers from anxiety disorders. Every fifth Indian suffers from anxiety disorder. People with stress and anxiety disorders are often reluctant to seek medical help because they feel embarrassed about it. In fact, having anxiety doesn’t mean you are crazy and it’s not your fault you experience it. It’s very similar to having a high blood pressure or diabetes.

Common signs of stress and anxiety

Stress and anxiety share a lot of symptoms. It could be a little challenging to differentiate between stress and anxiety.

Restlessness

  • “ No matter how hard I try to relax, I just couldn’t relax my mind and body”

Chest and other body aches

  • “ There’s always a tightness around my chest and neck area, at times I feel that I am about to a                heartache and faint”

Unable to concentrate

  • “I find it difficult to concentrate on what my friend is saying to me and then I can’t recall the details of    the conversation”

Poor memory

  • “ I struggle to remember minute things like my car keys, switching off stove”

Unable to switch off

  • “I am always preoccupied with worrying thoughts. I try hard to switch off my worries, but it doesn’t        work”

Racing mind

  • “My mind seems to be having a race with thoughts. I spend a lot of time worrying about future,           people and situations that have a very narrow chance of coming true. For example, what if I lose my   job, what if my plane crashes while landing, what if I am stuck in lift”

Poor sleep

  • “ I get to sleep okay, but I don’t feel very refreshed the next morning and wake up with hundreds of thoughts”

When does anxiety become clinical?

We all feel anxious in different situations like while giving a talk or during an interview. Experiencing anxiety in situations where we are liked to be judged is completely normal. But if the anxiety tends to hang around even after the stressful situation has passed then it’s not normal.

It is absolutely normal to experience anxiety at times, for e.g., during an event where you are likely to be judged, or could you as simple as cooking for your guests.

Worrying is helpful provided it is turned into a plan for action, or when it helps you pay attention and helps you better prepared for the future. For e.g., “what would you do to cope with your financial crisis”? It would make you act on a plan to help you prevent any future crisis.

However, anxiety becomes a disorder when it starts to affect your daily life activities. It becomes a problem when you are experiencing it a lot, in situations that should not be really scary or stressful.

Types of anxiety disorder

Sometimes anxiety is experienced in a specific way and is identified as a specific anxiety condition. The most common types of anxiety disorders are:

  • Generalized Anxiety Disorder
  • Panic Disorder
  • Social anxiety
  • Specific phobias
  • Obsessive Compulsive Disorder
  • Post Traumatic Stress Disorder

Generalized Anxiety Disorder or Free Floating Anxiety

All of us feel anxious and stressful from time to time when we are faced with a challenging situation like deadlines at work, exams, or a job interview. The anxiety that we experience in these challenging situations can help us in staying alert and motivates us to get things done.

However, some people may feel tense and anxious most of the time. For them, it’s an impossible task to relax. Even petty things like daily household chores can lead to uncontrollable worry and anxiety so much so that they start to interfere with their daily lives.

Signs and symptoms

People suffering from GAD may experience signs such as headaches, rapid heart rate, uneasiness around chest and stomach, excessive sweating, inability to relax and sleep etc. Often these experiences can become worse when the individual has nothing big to work on e.g. after work or while lying on bed.

Panic Disorder

Panic disorder is a state of extreme and intense anxiety accompanied by unreasoning fear. They tend to occur out of the blue and involve a strong feeling that something terrible is going to happen.

Signs and symptoms

The commonly experienced physical symptoms of panic attack are:

  • Breathlessness
  • Chest discomfort or pain
  • Hot flashes
  • Fear of dying and fear of not being in control of oneself or going crazy
  • Nausea, dizziness and trembling
  • Abdominal distress

Panic attacks can happen anywhere, anytime and without warning. The person may live in a fear of another attack and might avoid places where they had an attack. For e.g. avoiding busy places or closed spaces.

Sometimes the physical symptoms can be noticed due to other medical conditions such as an illness (flue) or if your blood sugar level is low.

Social Anxiety

It’s a very common experience to feel anxious having to talk in front of a bunch of people, or doing a presentation at work. It’s equally common to experience nervous when meeting strangers or people we know.

However, for people with social anxiety disorder, the social situations can result in experience of intense anxiety. They may fear of being judged, made fun of, and getting humiliated even in ordinary everyday situations. For e.g. the thought of going out for an office lunch/dinner can be daunting for people with social phobia.

Signs and symptoms

Some of the commonly experienced signs of people suffering from social anxiety are:

  • Stammering when trying to speak or speaking too fast
  • Excessive worry that they will say something wrong
  • Avoiding situations or people because they fear that their words or behaviors might result in bringing humiliation or embarrassment.
  • Excessive sweating, trembling and racing heart when having an interaction or when trying to speak.

 Specific Phobias

Many of us have a fear for snakes, lizards, heights or taking a flight. Fear about certain things, situations or an animal is very common. Fear is generated by our body’s natural defense mechanism to situations called fight or flight which pose a threat to our safety.

However, some people react to these fears by exaggerating the risk in their minds. This includes the experience of lasting, uncontrollable and unreasonable fear triggered by the presence of just a mere thought of a specific object or situation that poses no or very little danger. The experience of these unpleasant and intense anxiety symptoms results in avoidance of the situation or object. People with specific phobias are able to recognize that their fear is unreasonable and irrational, yet are unable to resist it.

Panic attacks are often experienced with specific phobias during which the mere mental image or exposure to the phobic situation causes overwhelming physical sensations which include palpitations, dizziness, pounding heart, chest pain etc.

Types of specific phobias

The commonly experienced types of specific phobias are:

  • Animal phobia: Fear that relates to animals or insects. Examples include the fear of dogs, snakes, spiders etc
  • Natural environmental phobias: This involves the fear of heights, water, cyclones etc
  • Blood/injection/injury phobia: Examples include fear of invasive procedures, blood, or being infected with various infections. This kind of phobia is commonly seen in people suffering from Obsessive Compulsive Disorder.
  • Situational Phobia: This includes fear of specific situations like being in closed spaces (elevators, malls), driving over a bridge, being alone at home or taking a flight.

Signs and symptoms

The commonly experienced signs if you have a specific phobia are

  • Persistent, excessive, and unreasonable fear of a specific object, activity or situation. For example heights, spider, blood, elevators etc.
  • Avoiding places and situations where they may have to face phobic stimulus. For example fear of heights may lead to avoidance of the bridge on the way to work and taking another route even if causes delay in reaching work.
  • The anxiety about the phobic stimulus is so intense that it causes significant interference with other important areas of functioning like work, personal time or studying.

Obsessive Compulsive Disorder

Anxiety in moderation is helpful and can influence our behavior in a helpful way. For example, thought like “I might not have turned off the headlights” might result in checking your car headlights and keeping things safe.

However, if that thought becomes rumination and gets you obsessed with it, then it could lead to unhealthy patterns of behavior and cause significant disturbance in your daily functioning. For example, excessive preoccupations like “I haven’t cleaned my hands properly’ or “I might not have turned off the gas” might lead to excessive washing and checking.

OCD is a common and chronic condition where the person experiences uncontrollable and recurring thoughts (Obsessions). In order to deal with these recurrent thoughts (obsessions) the person has an urge to repeat certain behavior again and again. For example, obsessive thoughts about fear of contamination may lead to repeated washing and avoiding certain things (compulsions).

OCD can be quite distressing and can lead to lot of frustration, but medication and therapy can significantly help to keep it under control.

Signs and symptoms

Signs that are commonly associated with OCD are frequent obsessive thoughts are compulsive behaviors discussed above. Other common signs are:

  • Obsession centered on excessive cleanliness or order:

This includes repeated hand washing or cleaning to reduce the fear of contamination.

  • Checking on:

This includes symptoms like frequent checking of doors, gas stoves or headlights to reduce the anxiety of being unsafe.

  • Counting:

This includes repeated counting of items or things such as shops, or idols while walking.

  • Religious issues:

A compulsion to pray in a certain way or in a certain time each day to avoid something bad from happening.

Post Traumatic Stress Disorder

PTSD is a form of anxiety disorder which can develop in people who were involved in or witnessed traumatic events which threatened their safety or that of others around them. This could be a death of a family member, post war trauma, assault, or an accident.

What is it like to have PTSD?

When you go through a traumatic experience, it’s likely that you would experience some signs of PTSD such as having difficulty falling asleep, restless, or anxious thoughts. This is known as “acute stress reaction”. But slowly these symptoms disappear with time. However, people having PTSD may find it really difficult to get away with thoughts relating to the traumatic experiences.

“I started experiencing symptoms of PTSD after I survived a physical, mental and sexual assault. I had recurrent flashback which would remind me of the same incident which took place then. These flashbacks could happen anytime, anywhere and were extremely dreadful. It was like reliving those years”. I wouldn’t understand why my brain wasn’t able to cope with it. Not being able to sleep and the sense of never being at peace were exhausting”, says a person with PTSD.

Signs and symptoms

  • Reliving the traumatic experience: Experiencing flashbacks, nightmares about the traumatic event often in the form of vivid images. This may result in having extreme and intense emotional and physical reactions such as racing heart beat, palpitations, sweating, dizziness etc.
  • Avoidance behaviour: Avoidance of people, situations or things which might bring back memories of the traumatic event.
  • Hyper Vigilance: Being alert most of the time. The person might even experience difficulty falling asleep, might not be able to concentrate enough.
  • You might feel less interested in other people and might not enjoy your favorite hobbies or interests.
  • Inability to sleep, snapping at people for small things and feeling low most time of the day.

What causes anxiety and what keeps it going?

Though anxiety is caused in a situation where our body detects a threat, (physical or psychological) there are certain factors which maintain anxiety and keeps it going.

While there could be a traumatic life experience causing anxiety disorder, most of the times it’s a combination of multiple reasons for experiencing anxiety disorder.

Traumatic life events

People can develop anxiety disorders following a chain of traumatic experiences. If someone experiences many different stressful situations all at once then that further increases the risk of developing an anxiety disorder. For example, if someone has work related pressures, financial crisis and a challenging married life, all at the same time then it is not unlikely that they would become anxious.

Thinking patterns

We all tend to think negatively at times. However some people may have a thinking style that makes them more prone to experience anxiety disorder and other related problems. For instance, anxious personality people have a tendency to always predict things negatively and engage in more self destructive thoughts. They might feel that thinking about these future possibilities would help them to cope if something goes wrong in the near future. However, this is not true. In fact, constant worry would always make them to be on ‘alert mode’ which would make it difficult for them to relax.

Maintaining Factors of Anxiety Disorder

Though anxiety disorders are developed by a combination of a lot of factors like traumatic events, genetics, thinking style of the person etc, it is then maintained by few factors such as our predominant way of perceiving things and our behaviour.

Thinking style that keeps anxiety going

Some people usually have a tendency to overestimate the likelihood of bad things happening, or predict the worst case scenarios. This kind of thinking adds to the already existing anxiety and keeps it going. When we are under constant anxiety and stress, it compromises our capacity to think logically and as a result we end up thinking more negativity. Soon it becomes a vicious cycle which goes on and on.

Anxious people also sometimes believe that their worrying would help them prepare for the future if they had to face a crisis. However, when they are constantly on the “alert mode’ they also develop a tendency to find threat in potentially safe situations. These beliefs often doesn’t come true and make us more anxious.

A lot of people “worry about their worrying”. They spend a lot of thinking about their physical symptoms of anxiety which would in turn cause them more anxious. That’s where it again becomes a vicious cycle.

Behaviours that keep anxiety going

Both anxiety and behavior are closely interlinked and influence each other. Due to anxiety, some people tend to change their behaviour or avoid certain situations which in turn increase their anxiety. For example, a person with social phobia might avoid going to a party which will make him more anxious about people and gatherings. Over dependence on alcohol, drugs or cigarettes to deal with certain situation would have the effect. These are often called as “avoidance behaviour”. Although avoidance might give you some temporary relief, it would not give you an opportunity to learn to cope with it. Things often get better when we learn to manage the situation in healthier ways rather than trying to avoid it by indulging in avoidance behaviour which would only make the situation worse in the long run.

Too much or too little time to relax

Not having enough time to relax can impact significantly on your anxiety levels. Having quality time to do things that you enjoy can help you relax and find purpose in life. On the other hand, having too much of leisure time can also increase your anxiety levels as you would spend too much time worrying about things.

 

MANAGEMENT OF ANXIETY

Understanding your anxiety

Developing an understanding about anxiety would help in accepting the feeling, which in-turn would aid in managing anxiety.

There is enough anti-anxiety advice in the world, but none of this will make sense unless it’s put into action. There are various ways to cope with stress and anxiety but it’s important to remember that not everything will work with everyone. Different things work for different people. A lot of strategies might not give you immediate results because they work on building a habit. Like any other habit, psychological strategies also take time and consistency in practice to show results.

The following strategies will be helpful in managing your anxiety. A lot of people might have done this already but not with much noticeable change. But the key to success is consistency in practice. Similarly, due to its unpleasant nature, there could be an urge to get out of the situation as early as possible. However if you try to learn all strategies at one go, then you are unlikely to stick to it for a longer time. It’s always advisable to make one change at a time rather than trying to change everything once.

What makes us Anxious?

By learning more about anxiety and why we experience it, would help us understand that anxiety is a natural experience. By exploring anxiety more closely, we can see that anxiety is not a harmful experience. In fact it’s our body’s natural response to keep ourselves safe from external threat.

All the unpleasant experiences that one has during anxiety phase are due to something called as “fight or flight” reaction. Fight/flight is our body defense mechanism which turns on when we face a physical threat. It prepares our body to either fight with the threat or to escape from it. For example, during anxiety your heart starts to beat faster and faster. Now that because your heart is trying to pump more blood to your muscles. Similarly, you would sweat a lot, that because your body is trying to cool you down. All these responses would help us to fight the danger or to escape from the danger. Now we know that all these unpleasant experiences are actually trying to protect us.

Today we do not face as many physical threats as we had a few centuries ago. However, we still experience these signs while not faced with physical threats. Why? It’s because today we have a lot of psychological threat which is triggering this defense mechanism such as deadlines, relationship issues, financial crisis etc. The strange part is human brain cannot differentiate between a physical and psychological threat and what it does is, to set the alarm when it detects the threat.

However, the good part is all these symptoms are not dangerous or harmful no matter what’s the origin of the threat is. All these symptoms are essential responses but probably experiences at the wrong time. Remembering this can be helpful in being less fearful about your symptoms which will allow it to pass sooner.

Unhelpful Thoughts

We face situations where we tend to experience unhelpful thoughts. That’s very natural as nobody is immune from negative thoughts. However experiencing these unhelpful thoughts often can cause significant disturbances in our life.

Identifying unhelpful thoughts

A lot of our thoughts are automatic and random. Majority of our thoughts are based on our past experiences and belief system. While we tend to get both helpful and unhelpful thoughts, it’s these unhelpful thoughts which do a lot of damage to our mental well being. These unhelpful thought patterns are faulty ways of thinking that reinforce negative thoughts or emotions.

The first step in challenging these unhelpful thought patterns is to identify them. Once you can identify your unhelpful thinking styles, it becomes easy to notice and then to challenge them. Their frequency becomes more, just before and during stressful situations.

Unhelpful Thought Patterns

The following are few commonly used unhelpful thought patterns.

Mind Reading

This is where you try to assume about other person’s beliefs without having any facts to support them.

  • “They think I am a stupid”
  • “My boss thinks I am a loser”

“Black and White” Thinking

This is where you see everything in a black and white fashion, with no shades of grey. There is no room for any middle grounds. In other words, everything is seen in terms of extremes – someone is either too good or too bad.

  • “ I gave a terrible presentation today, that means I am good for nothing”
  • “She didn’t accept my invite to connect which means that she hates me”

Jumping to conclusions

This is where you jump to conclusion about people/situations with little to no evidence to support it.

  • “She didn’t attend my call…..this means, She is upset with me”

Personalization

Personalization is attributing something negative to the personalities, which means believing that you are in some way wholly or partially responsible for all the bad that happens around you.

  • “They couldn’t enjoy their day out today because I was late”

(This mostly won’t be the original reason. But this thinking makes anxious)

Filtering

Focusing merely on the things which went bad and ignoring all the positives. A common example of filtering is when a couple in a relationship just thinks about one negative comment made by the other partner and views the relationship as hopeless, while ignoring all the compliments and experiences given in years of togetherness.

Emotional response

Here the person believes that their unpleasant feelings have significance to external events.

  • “If I feel it, it must be true”

Global Labeling

Global labeling is generalizing one or two instances to reach an overall general conclusion.

  • I was interviewed a couple of times and couldn’t manage to make it to the final list….I am terrible at interviewing and will never get a job in my lifetime.

Catastrophizing

This is where you blow things out of proportion. If something goes wrong then you assume the worst case scenario wherein you magnify the negative things which might happen.

  • “ I feel little sick today, I am going to have a cardiac arrest and die soon”

These unhelpful thoughts are common and a lot of us experience them at some point in our life. But some people experience them more often than others which lead to unpleasant emotions. But the good news is we can learn strategies to challenge these unhelpful thought patterns.

The next part of our section will discuss about how we challenge them to come up with a more balanced thought which is close to reality.

Challenging Unhelpful thoughts

Once we are able to identify our unhelpful thoughts, we can then learn to tackle them and so, challenge them.  Majority of your thoughts would be opinions based on past experiences. The following questions would be very helpful in challenging your unhelpful thoughts.

Is there any evidence which contradicts your thoughts?

Though I feel much of the time that I would collapse while the plane is landing, that never happened. I’ve always done well to control my anxiety. I know that these symptoms are of flight/flight and they are not dangerous.

What are the pros and cons of thinking in this way?

Pros: Can’t really thinking of any

Cons: It really makes me feel sick

Will this matter to you in 1 year time?

It might sound a little funny, when I probably look back later.

Is there any other way of looking at this situation?

I’ve done pretty well in similar situations. Even if something goes wrong, I am sure that there would be medical help available to take care of me. I should be okay.

CBT Thought Journal

Have you ever felt that you’re unable to understand the reason behind experiencing a certain emotion like irritation? Have you ever seen somebody saying “I don’t know but I feel anxious today’? Keeping a record of events and the thoughts which followed the trigger can really help you make sense your emotions better.

Cognitive Behavioral Therapy (CBT)

Cognitive Behavioral Therapy (CBT) is a kind of talking therapy that can help you manage your problems by changing the way you think and behave. It is based on the concept that our thoughts, feelings, body and behavior are all interlinked and tend to influence each other all the time. This means that the way you think is the way we feel and behave.

Writing this thought journal will help you understand how your negative thoughts are influencing you emotions and behavior. We learnt in the previous section how unhelpful thought patterns like catastrophizing, labeling, jumping to conclusions etc trap us in a vicious cycle. Writing this journal will aid you in identifying your unhelpful thought patterns.

How to write thought record

Describe the anxiety provoking situation in which the negative thought arose. Also make a note of where you were and what were you doing during the event.

  • The next step is to rate your levels of anxiety the situation evoke on a scale of 0 (lowest) to 10 (highest).
  • Write down the negative thoughts that came into your mind due to the anxiety provoking situation. Make a note of which unhelpful thought patterns belong to, like for example, black or white thinking, predicting the future etc.
  • After you have identified the negative thought, write the evidence which supports your negative thought along with evidence against it.
  • Now think of an alternative thought to replace with the automatic negative thought.

Finally, re rate the strength of your emotion or feeling. You would slowly start to notice that the intensity of the unpleasant feeling and frequency of negative thought comes down when we evaluate our thoughts in evidence based approach.

Differentiate between opinions and facts

A majority of our unhelpful thoughts are just opinions which are based on our past experiences and are NOT FACTS. Just because we are having them doesn’t necessarily make them true. Facts are not opinions. In order to make helpful changes, facts are what we need to focus on. The first step in challenging these unhelpful thoughts is to think whether the thoughts that you are experiencing are opinion or facts.

This simple exercise will help you learn the differences between an opinion and a fact. The exercise involves 10 statements from which you must decide if they are either facts or opinions.

These are:

  • I am bad person (fact) (opinion)
  • This will be a mess.
  • She couldn’t clear her exam
  • I didn’t lend my friend money when they asked
  • I am overweight
  • She thinks that I am a bad person
  • My friend just told me that he might be hurt because of my behavior today.

Once you indicate your answers, you would know the right answer for these statements followed by an explanation of why it is a fact or an opinion.

Decatastrophizing

People experiencing anxiety disorders might fear a certain situation. They tend to predict the worst case scenarios possible for that event which further adds to their anxiety. Learn to disassociate the traumatic experience and event here. This strategy would help you deal with the challenging negative thought particularly with catastrophizing.

Pen it down

Write the catastrophe that you are worrying about. You should clearly state the worry without using “what if…? Statements. Next is to rate how sure you are about the catastrophe coming true in a scale of 0 (not at all) to 10 (very much likely). Try to think how many times in the past have you felt like this and how many times did that actually happen. With the frequency in mind try to make a logical guess.

Once you have made a logical guess, now move on to think the worst case scenario and also the best case scenario if the catastrophe comes true.  If it was to happen then what is the worst that would happen and what is the best that could happen. Now that you know how worse it would be, if the catastrophe comes true, think about how you would cope with it. Think about all the resources you have at your disposal to help to cope like you friends and family, skills and abilities that you have.

This exercise can be a very good resource for anyone who tends to worry excessively about a potentially negative event.

Improving problem solving skills

Stress compromises our ability to think logically. People suffering from anxiety disorders often tend to worry a lot about their problems instead of learning to deal with problems. This article will provide few tips on improving your problem solving skills.

Problem Solving Therapy

Problem solving therapy is gaining a lot of significance these days. It’s a form of psychotherapy which can help to improve the mood of the individual suffering from anxiety and depression by helping them to resolve the problems. The problems encountered by the individual are focused with an aim to find the workable solutions for them.

In this technique, emotions are put aside and both the therapist and the client works together on the challenges that the client is having difficulty with. It’s always a good idea to start with simplest problems before moving on to more complex ones. Your problem solving skills can be improved by applying the tips outlines here.

  • Clarify your problem by asking yourself “what is the problem”. Try to be as specific as you can.

                 “I make a mess when I try to give a presentation”

  • Once you have identified your problem then try to list the goals that would want to achieve out of this.

                  “I want myself to be more confident when I am speaking”

  • After you identify your problem and have goals to achieve, try to list all possible ways you can think of to overcome your problem. A good idea is to work it out on a piece of paper. Try to think how you dealt with similar problems in the past. How would you advice a friend of yours with similar problems.
  • The next step is to select the best possible solution from your list. You may want to write the “pros” and “cons” for each solution. This would help you in weighing each option. If you have more than one idea that seems to be doable, then try to pick one to begin with. If it doesn’t work then can always try out the other one.
  • Now once you have the preferred idea, work on ways to implement the solutions. Break your idea down into several micro steps to achieve your final goal.
  • Don’t forget to evaluate the outcome. Try to brainstorm what went well and what went wrong. How would you deal with the same problem the next time you encounter it.

Learning to Relax

(Deep breathing, PMR, Visualization/ Guided Imagery)

Relaxation is an inevitable part of anxiety management. Not only does it revitalizes but also improves your ability to cope with stress better. Learn more about relaxation in this article.

We all have extremely busy lives, in which work life balance remains a challenge for many of us. For some years now, the things that we use to relax ourselves have changed drastically. For some people, relaxation means lying on a sofa in front of the television at the end of a stressful day.

This may actually help only to a certain degree. To effectively overcome stress and anxiety, we need to incorporate a relaxation routine in our daily routine. This could include activities such as deep breathing, mindfulness, yoga, meditation etc.

These can be really helpful in calming your body and thoughts.

Relaxation can also involve doing something that you really enjoy, like painting, gardening or reading a book. Try to take out time to relax yourself daily. For some people taking out time for themselves might seem like a luxury. But remember that it’s a NECESSITY.

The following few relaxation exercises that specifically designed to help you calm your mind and body.

Deepbreathing

This breathing exercise involves focusing on your breathing patterns. This exercise is particularly helpful for people experiencing symptoms of anxiety such as dizziness, rapid heart rate, palpitation etc. The idea here is to notice the way you are breathing. Quite often people who are anxious use their chest for breathing instead of stomach which leads to hyperventilation. Deep breathing exercise will help you learn ideal breathing by using your full lung capacity. 

Progressive Muscle Relaxation (PMR)

A lot of times, when we are in tension we subconsciously tense in few parts of our body which leads to further anxiety. We are so used to this feeling of tension then we might not realize that it’s tensed. This is where PMR can help in understanding our body in a better way.

PMR is a very effective way to relax your body when feeling anxious. It starts by trying to relax systematically by relaxing different muscle group in the body. Initially, you might not notice the change but with practice you would develop a good understanding on how your body would be under pressure and how to go about relaxing it.

Visualization/Guided Imagery

This technique involves imagining a place that is calm and comforting. Visualization is not only used to cope with anxiety and depression but could also be used in our daily lives before a stressful situation. For example, before your presentation, you can imagine giving a successful talk and making an impact on the audience.

Visualization and guided imagery are very similar except that in Visualization you can choose your own setting and in guided Imagery. A therapist or audio will guide you to imagine the setting.

Dealing with avoidance behavior

Stress and avoidance are closely interlinked. Not only does stress and anxiety leads to avoidance of certain things but avoidance can further lead to more stress and anxiety. So it becomes very important to learn to deal with avoidance behavior.

Avoiding Everything

Stress can make you avoid different things, places, situations and sometimes people. Avoidance can help you in the short run but it only makes the problem worse when you continuously engage in it over a period of time. When feeling stressed, we tend to avoid doing nothing about our problems, in the hope that they will somehow go away on their own. But the fact is that they won’t. Sometimes avoidance for too long can result in phobias.

Whatever it is that you’re avoiding – people, situations or tasks, FACE THEM. Break them down to smaller, achievable tasks and handle them one by one. Developing your problem solving skills is a very good way to deal with avoidance behaviour.

General well being

Things like exercise, food and sleep can have a major impact on your stress and anxiety levels. Quite often they are not taken seriously but they can be really beneficial in controlling anxiety and stress.

It is well known that unhealthy eating patterns can bring changes to your body. However food doesn’t only affect our physical health but also our mental well being. Many scientists have said that ‘we are what we eat”. Several studies have detailed about how some foods can deteriorate your mood while others might help you feel better.

Food and Mood

There is growing research which argues what we eat is what we feel. Ever wondered the reason behind those cravings for food when feeling down? Some people might find this especially true with sugars. Thought anxiety disorders and stress are not likely to be caused by food alone, there is growing evidence that says that sugar might lead to mood fluctuations.

It is really important we eat regularly, especially patients suffering from diabetes. If your blood glucose levels drop then there is a chance that you might feel tired and irritable. Therefore, instead of eating three large meals a day, try having smaller portions at regular intervals throughout the day.

It is always better to avoid food which makes your blood sugar to rise and fall rapidly like sweets, soft drinks etc. It can cause mood swings.

Get your 5 a day. Vegetables and fruits are enriched with vital vitamins, minerals and fiber. We need them not only to keep us going but also for our mental fitness.

Try to have at least five good varieties of colored vegetable and fruits in your diet. This will make sure that you get all the required nutrients to keep your overall fitness intact.

Check on your caffeine intake

Many of us are aware that caffeine is a stimulant which means it would keep your brain alert and active for some time. But it can also make you feel anxious and interfere with your sleep when taken in excessive amounts. This is especially true if you are having a hot cup of coffee just before going to bed. Many of you might also have experienced withdrawal effects when you suddenly stop caffeine intake.

Be active

We all are very well aware that being physically active has numerous benefits to our body. But how many of us are aware that exercise has equally important mental benefits too? Thirty minutes of exercise at least five days in a week, can create immense positive impact on our mental well being. Physical activity releases happy hormone called “endorphins” which helps us in fighting stress and staying positive.

So what counts as an exercise? Any activity that increases your heart rate counts as an exercise. So it could a brisk walk, a light jog or using your stairs instead of taking a lift. Above all, exercise is really beneficial for people who are having difficulty falling asleep, as it would help you sleep better.

Good night sleep

How many times have you noticed getting up a little annoyed and frustrated when you had to wake up several times during the night? Sleep more or sleeping less can both be red flags and can lead to psychological issues later on in life. Not to be able to go to bed, getting up frequently during sleep or inability to go back to sleep once you’re up, are all indications of sleep problems.

Remember the old nanny saying “Having a glass of warm milk before sleeping helps in better sleep”? Milk helps in the production of melatonin which helps in having a good night sleep. Paying a little more attention to your pillows, mattress or blinds might help you develop insights into your room. As well, using your bedroom activities other than sleep might not be a good idea.


Santhoshini Datla

I have a post graduate degree in Applied Psychology followed by 4yrs of clinical experience in Indian Naval Hospital Kalyani and NHS United Kingdom. In the last few years, I have been delivering evidence based Cognitive Behavioural Therapy for depression, anxiety and other stress related psychological issues. Psychological well-being is not just mere absence of mental illness but also having good quality of life. There are days when we all feel down, demotivated and lost which is absolutely normal. But if it goes on for a significant period of time and starts affecting your daily life then that it when we need professional help. In psychological therapy I would be helping in making sense of why you feel the way you feel, facilitate you to make better healthier choices, help you learn to think in a way thats more helpful for your mental health and with an overall aim of making clients more independent so much so that they are confident of dealing with challenging situations in the future themselves.

4 Comments

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