Overcoming Anxiety For Dummies, 2nd Edtion

by Smith, Laura L.

  Blurred vision

  Disorientation

  Jitteriness

  Loss of consciousness

  Muscle cramps

  Rapid pulse

  Tingling sensations in the extremities or face

  Anxiety and relaxation make for strange bedfellows

  Have you ever known two people who couldn't be in the same room at the same time? If they show up at the same party, trouble is bound to brew. They're like oil and water — they just don't mix.

  Anxiety and relaxation are a little like that. Think about it. How can you be anxious at the same time that you're relaxed? Not an easy accomplishment. Psychologists have a term for this phenomenon: reciprocal inhibition. Many psychologists believe that the techniques described in this chapter work because relaxation inhibits anxiety, and vice versa. Training yourself diligently in the use of relaxation skills should help you inhibit your anxiety.

  Hyperventilation frequently accompanies panic attacks as well as chronic anxiety. The symptoms of over-breathing feel like symptoms of anxiety, and people with anxiety disorders may hyperventilate. Therefore, finding out how to breathe properly is considered an effective tool for managing anxiety.

  Discovering your natural breathing pattern

  When you came into the world, unless you had a physical problem with your lungs, you probably breathed just fine. Look at most babies. Unless they're in distress from hunger or pain, they need no instruction in how to breathe or relax. Their little tummies rise and fall with each breath in a rhythmic, natural way. The stresses of everyday life, however, have since meddled with your inborn, natural breathing response.

  Under stress, people usually breathe shallow and fast, or, sometimes, they don't breathe at all. Some people hold their breath when they feel stressed and aren't even aware that they're doing it. Try noticing your breathing when you feel stressed, and see whether you're a breath-holder or a rapid, shallow breather.

  You can also check out how you breathe when you're not stressed:

  1. Lie down on your back.

  2. Put one hand on your stomach and the other on your chest.

  3. Notice the movements of your hands as you breathe.

  If you're breathing correctly, the hand on your stomach rises as you inhale and lowers as you exhale. The hand on your chest doesn't move so much, and to the extent that it does, it should do so in tandem with the other hand.

  The odds are that if you have a problem with anxiety, your breathing could use a tuneup. That's especially so if you have trouble with panic attacks. Breathing practice can start you on the way to feeling calmer.

  Breathing like a baby

  Abdominal breathing involves breathing with your diaphragm — the muscle that lies between your abdominal cavity and your lung cavity. Try this exercise to start breathing slowly and deeply, like a baby again. You may want to lie down, or you can do this while sitting as long as you have a large, comfortable chair that you can stretch out in. Follow these steps:

  1. Check out your body for tension. Notice whether certain muscles feel tight, your breathing is shallow and rapid, you're clenching your teeth, or you have other distressing feelings.

  Rate your tension on a 1-to-10-point scale, with 1 representing complete relaxation and 10 meaning total tension.

  2. Place a hand on your stomach.

  3. Breathe in slowly through your nose, to a slow count of four, and fill the lower part of your lungs.

  You're doing this correctly if your hand rises from your abdomen.

  4. Pause and hold your breath for a moment.

  5. Exhale slowly, to a slow count of six.

  Imagine your entire body is deflating like a balloon, and let it go limp.

  If you find this hard to do at first, exhale to a count of four. Later, you'll find that slowing down to a count of six is easier.

  6. Pause briefly again.

  7. Inhale the same way you did in Step 3, slowly through your nose to a slow count of four.

  Check to see that your hand rises from your abdomen. Your chest should move only slightly and in tandem with your stomach.

  8. Pause and hold your breath briefly.

  9. Exhale as you did in Step 5, to a slow count of six.

  10. Continue breathing in and out in this fashion for five minutes.

  11. Check out your body again for tension, and rate that tension on a scale of 1 to 10.

  We recommend that you do this abdominal breathing exercise at least once a day for five minutes, ten days in a row. For that matter, it isn't difficult to do this four or five times each day — your gains will pile up more quickly. You can do this breathing just about anywhere, anytime. You'll find it relaxing, and it won't add stress to your day by taking away valuable time. After you do that, try noticing your breathing at various times during your regular routine. You'll quickly see whether you're breathing through the diaphragm or the upper chest like so many people do. Allow your diaphragm to take charge of your breathing. Slowly but surely, abdominal breathing can become a new habit that decreases your stress.

  Consider keeping a record of your tension levels before and after this exercise. Over time you're likely to see concrete evidence that it works.

  Whenever you feel anxiety or panic coming on, try using abdominal breathing. You may head it off at the pass. On the other hand, anxiety, and especially panic, may rise to a level that makes these exercises more difficult. If that happens to you, try the panic-breathing technique that we explain in the next section.

  The benefits of controlled breathing

  Just in case you think that breathing better sounds like a rather unimaginative, simple way of reducing anxiety, you may want to consider its healthy effects. Studies show that training in breathing can contribute to the reduction of panic attacks within a matter of a few weeks. Other studies have indicated that controlled breathing can slightly reduce blood pressure, improve the heart's rhythm, reduce certain types of epileptic seizures, sharpen mental performance, increase blood circulation, quell worry, and possibly even improve the outcome of cardiac rehabilitation efforts following a heart attack. Not a bad list of benefits for such a simple skill.

  Using panic breathing in high-stress situations

  Now and then, you need a faster, more powerful technique to relax. Perhaps you went to the mall and felt trapped, or maybe you were on your way to a job interview and felt overwhelmed. Whatever the situation, when stress hits you unexpectedly, try our panic-breathing technique:

  1. Inhale deeply and slowly through your nose.

  2. Hold your breath for a slow count of six.

  3. Slowly breathe out through your lips to a count of eight, making a slight hissing sound as you do.

  That sound can be so soft that only you can hear it. You don't have to worry about anyone around you thinking that you're crazy.

  4. Repeat this type of breath five or ten times.

  You may think that panic breathing is difficult to do when stress strikes suddenly. We won't deny it takes some practice. The key is the slight hissing sound, which gives you a much easier way to slow down your breath.

  If panic breathing doesn't help, and you feel like you may be having a full-blown panic attack that won't go away, try breathing in and out of a paper bag with the opening wrapped around your mouth. Breathing this way rebalances the ratio of oxygen to carbon dioxide and should cut the panic attack short. When you breathe too rapidly, your body accumulates an excess of oxygen, although it feels like you have too little of it. Breathing in the bag brings the level of carbon dioxide up to normal.

  Don't start carrying a paper bag with you everywhere you go. You need to learn to cope with the fact that sometimes, panic attacks just happen and that you'll live through them if they do.

  Relaxing Your Whole Body

  Some of you may find that breathing techniques quell your anxiety quickly. Others may require a technique that directly aims at total body relaxation. Relaxing your body takes some time and practice, but
it's worth it.

  Over a half century ago, Dr. Edmund Jacobsen, a Chicago physician, developed what has come to be the most widely used relaxation technique in the United States, progressive muscle relaxation. You can find a wide variety of similar techniques, all described as progressive muscle relaxation, in various books and journals. Each of them may use different muscle groups or proceed in a different order, but they all do essentially the same thing.

  Progressive muscle relaxation involves going through various muscle groups in the body and tensing each one for a little while, followed by a quick letting go of the tension. You then attend to the sensation of release, noticing how the limp muscles feel in contrast to their previous tense state.

  Knowing what to expect

  You'll find it useful to look for the right place to do your progressive muscle relaxation. You probably don't have a soundproof room, but find the quietest place that you can. Consider turning the phones to silent mode. Choose some comfortable clothing, or at least loosen any clothing you're wearing that's tight and constricting. You don't need shoes, belts, or anything uncomfortable.

  Realize that when you begin tensing each muscle group, you shouldn't overexert; don't tighten using more than about two-thirds of all your effort. When you tense, hold it for six to ten seconds and notice how the tension feels. Then let go of the tension all at the same time, as though a string holding the muscle up were cut loose.

  After you release the muscle, focus on the relaxed feeling and allow it to deepen for 10 or 15 seconds. If you don't achieve a desired state of relaxation for that muscle group, you can do the procedure one or two more times if you want.

  You should know that you can't make relaxation happen. You allow it to happen. Perfectionists struggle with this idea. Don't force it, and rid your mind of the idea that you must do this exercise perfectly.

  When you tighten one muscle group, try to keep all the other muscles in your body relaxed. Doing this takes a little practice, but you can figure out how to tense one body area at a time. Keep your face especially relaxed when you're tensing any area other than your face. Yoga instructors often say, "Soften your eyes." We're not exactly sure what that means, but it seems to help.

  Occasionally, relaxation training makes people feel surprisingly uncomfortable. If this happens to you, stop. If it continues to occur with repeated practice, you may want to seek professional help. Also, don't tighten any body part that hurts. Avoid tightening any area that has suffered injury or has given you trouble, such as a lower back.

  Discovering the progressive muscle technique

  After you've read through the tips in the preceding section, you're ready to start. Sit down in your chosen place and get comfortable.

  1. Take a deep breath, hold, imagine, and let the tension go.

  Pulling the air into your abdomen, breathe deeply. Hold your breath for three or four seconds, and then slowly let the air out. Imagine your whole body is a balloon losing air as you exhale, and let tension go out with the air. Take three more such breaths and feel your entire body getting more limp with each one.

  2. Squeeze your hands tight and then relax.

  Squeeze your fingers into a fist. Feel the tension and hold it for six to ten seconds. Then, all at once, release your hands and let them go limp. Allow the tension in your hands to flow out. Let the relaxation deepen for 10 to 15 seconds.

  3. Tighten your arms and then relax.

  Bring your lower arms up almost to your shoulders and tighten the muscles. Make sure you tense the muscles on the inside and outside of both the upper and lower arms. If you're not sure you're doing that, use one hand to do a tension check on the other arm. Hold the tension a little while, and then drop your arms as though you cut a string holding them up. Let the tension flow out and the relaxation flow in.

  4. Raise up your shoulders, tighten, and then relax.

  Raise your shoulders up as though you were a turtle trying to get into its shell. Hold the tension and then let your shoulders drop. Feel the relaxation deepen for 10 to 15 seconds.

  5. Tighten and relax the muscles in your upper back.

  Pull your shoulders back and bring your shoulder blades closer together. Hold that tension a little while . . . then let it go.

  6. Scrunch up your entire face, and then relax.

  Squeeze your forehead down, bring your jaws together, tighten your eyes and eyebrows, and contract your tongue and lips. Let the tension grow and hold it . . . then relax and let go.

  7. Tighten and relax your neck in the back of your head.

  Gently pull your head back toward your back and feel the muscles tighten in the back of your neck. If you feel any pain, ease up to avoid hurting your neck. Notice the tension and hold it, then let go and relax. Feel the relaxation deepening.

  8. Contract the front neck muscles and then loosen.

  Gently move your chin toward your chest. Tighten your neck muscles, let the tension increase, and maintain it; then relax. Feel the tension melting away like candle wax.

  9. Tighten the muscles in your stomach and chest and maintain the tension. Then let it go.

  10. Arch your back, hang on to the contraction, and then relax.

  Be gentle with your lower back. Tighten these muscles by arching your lower back, pressing it back against the chair, or tensing the muscles any way you want. Gently increase and maintain the tension, but don't overdo it. Now, relax and allow the waves to roll in.

  11. Contract and relax your buttocks muscles.

  Tighten your buttocks so as to gently lift yourself up in your chair. Hold the tension. Then let the tension melt and the relaxation grow.

  12. Squeeze and relax your thigh muscles.

  Tighten and hold these muscles. Then relax and feel the tension draining out; let the calm deepen and spread.

  13. Contract and relax your calves.

  Tighten the muscles in your calves by pulling your toes toward your face. Take care: If you're prone to muscle cramps, don't overdo it. Hold the tension . . . then let go. Let the tension drain into the floor.

  14. Gently curl your toes, maintain the tension, and then relax.

  15. Take a little time to tour your entire body.

  Notice whether you feel better than when you began. If you find areas of tension, allow the relaxed areas around them to come in and replace them. If that doesn't work, repeat the procedure for the tense area.

  16. Spend a few minutes enjoying the relaxed feelings.

  Let relaxation spread and penetrate every muscle fiber in your body. Notice any sensations you have. Whatever you feel, allow it to happen. When you're ready, you can open your eyes and go on with your day, perhaps feeling like you just returned from a brief vacation.

  Some people like to make a recording of the progressive muscle relaxation instructions to facilitate their efforts. If you do, be sure to make your recording in a slow, calming voice.

  Extolling the virtues of progressive muscle relaxation

  Many people believe that for a remedy to be truly effective, it must take plenty of work and possibly feel a little painful — the no pain, no gain philosophy. As you can see, progressive muscle relaxation isn't especially arduous, and it actually feels good, so can it really do anything for you? Well, for starters, progressive relaxation training is usually a component of most successful treatment programs for anxiety.

  However, studies also show that progressive muscle relaxation can effectively reduce various types of chronic pain, such as the pain associated with ulcerative colitis, cancer, and headaches. It also works to reduce insomnia. A study published in the December 2001 issue of the Journal of Clinical Psychology found that in addition to inducing greater relaxation, progressive muscle relaxation also led to increased mental quiet and joy. Other studies have suggested that it may improve the functioning of your immune system. We aren't suggesting that progressive muscle relaxation cures cancer, and it won't whisk away all your pain or eradicate all your anxiety. However, many studies clearly
show that it exerts benefits across a surprisingly wide range of problems. We recommend that you give it a try.