Month: August 2016

Strategies for anxiety – physical

~ Superfluous G ~ 1 Comment

Anxiety requires a multi-pronged approach to loosen its grip. It is both physical and mental, and tackling both are equally important. This post focuses on the physical, and will discuss a few coping strategies. I’m also posting another one alongside it, which focuses on the mental. I’ll be fleshing out the coping strategies over coming posts.

 

Anxiety comes at you from all directions.

There’s the rampant speculation over rational fears; explosive terror over the irrational. The physical effects of an ocean of cortisol pumping around your veins. Anxiety’s there waiting for you when you get into bed at night, and wakes you up with a full English clusterfuck. It’ll jump you when you are out shopping, ambush you mid-conversation, and get in your face when you are just trying to relax.

For a mental health condition, anxiety is overwhelmingly physical. Cortisol – the drug your body produces to deal with stressful situations – is gushing around your body 24/7. This is great for dodging out the way of cars or last minute second wind efforts at work, but too much of it, and the side effects run you ragged. Here’s a brief list of physical symptoms of living with anxiety:

  • Headaches
  • Jaw clenching
  • Tight neck and shoulders
  • Stiff muscles
  • Inability to concentrate
  • Racing heart
  • Shallow breath
  • Heart palpitations
  • Tremors
  • Hair loss
  • Weight gain/loss
  • Itching and sore patches
  • Tinnitus
  • Loss of appetite
  • Spots and lumps
  • Vision distortion (seeing things out of the corner of your eye etc)
  • Sexual dysfunction
  • Hilarious bowels
  • Insomnia
  • Sore throats
  • Random infections lasting ages

In short, anything that isn’t actually killing you is probably linked to your anxiety. What’s going on here is that your body is in fight or flight mode around the clock. Consequently, you are burning the candle at both ends. You spend all your energy fuelling this heightened state of alertness, and your body is running on combat drugs alone.

Reducing your body’s production of cortisol is a catch 22 situation. You are producing cortisol because you are anxious, and you are anxious because there’s a ton of cortisol coursing through your blood. To lessen the physical, you must also work on the mental in tandem, but that’s not to say there’s nothing you can do with your body to help facilitate things.

Right at the top of the list is regular exercise. I cycle everywhere, and have been steadily increasing the number of days a week I’ve been hitting the gym since I started writing this blog. The results have been threefold.

First, I’ve managed to lose a fair chunk of weight – a whole 10k in six months. Hypochondria has played a massive role in my overall anxiety. Through drink, poor diet, drugs, and way too much sitting on my arse, I hit 30 with all the enthusiasm of a 60-year-old. The wheels were seemingly coming off, and when anxiety adds a dash of catastrophising to the mix, suddenly all you can think about is your impending demise.

Exercise helps solve this problem. If you are concerned to the point of despair over the state of your body and how resilient it is to illness, exercise is an obvious solution. You aren’t going to walk out of the gym looking like The Rock after a single session, but over time, you’ll move around with greater ease, slip into old clothes better, and spend more time looking at yourself in the mirror talking about how you are a total boss.

That boss feeling is the second boon of exercise: it makes you feel good about yourself. I do High Intensity Interval Training (HIIT) as part of my regular work out. You hit it as hard as you can for a few seconds per minute, and spend the rest of it at a moderate effort, every 60 seconds. People vary on it, but I like to go for the bike or the cross trainer, at 15 seconds flat out, 45 seconds moderate.

I started being able to this three times before collapsing in a sweaty dead heap. Now I can do it for fifteen minutes. Starting out is never easy, but the more you push yourself, the more rewarding it becomes. Each time I push myself a little further, I step out the gym in a blissful wash of endorphins, feeling like my problems aren’t impossible to conquer after all.

That’s the third part of it. Exercise is easy to do, and the results are easy to track. You are proving to yourself, with the most physical evidence you have available to you – your own body – that your efforts to tame anxiety are paying off. It doesn’t have to be the gym either – just whatever form of exercise you enjoy that you can do on a regular basis.

Alongside what you are doing with your body, it’s also crucial to think about what you are putting into it. My diet has been awful, and remains pretty bad – something that still requires some work. The old adage of you are what you eat remains true in the world of anxiety, and when you eat shit, you feel shit.

What you are aiming for is consistent energy that doesn’t crap out on you half way through the day. Missing breakfast means you will crash before lunch, and crashes bring cortisol. Same with sugar – those highs come with guaranteed lows.

With sugar, you are essentially messing with a drug. It’s addictive, it can easily become a crutch, and enough of it gets you high. Same with caffeine. You chug a couple of strong cappuccinos, you will be a jittery, semi-focused wreck for a few hours before crashing into a pit of neurotic apathy.

This is the problem with drugs, legal and illegal, prescribed or otherwise, in tackling anxiety. They can be distracting, even fun, and help alleviate anxiety in the short term. However, the long term effects can actually be detrimental to your efforts, and may even be one of the root causes.

My relationship with alcohol is a perfect example. Up until last week, I managed four months off the sauce. I had been aiming for a whole twelve, but ultimately caved at the Boomtown Fair festival – which is also the reason I’m running behind on the blog at the moment. But at Boomtown, drinking gallons of cider is part of the overall package of fun. It’s a special occasion I can let myself go and actually enjoy drinking. Besides, my liver’s had a lovely four-month long holiday – it was time to put it back to work.

The same cannot be said of my drinking before. I drank for fun then. But I’d drink for any reason. I’d drink alone. I’d drink out of boredom. I’d drink out of despair. I’d drink to stuff the demons back in their box. The result? Being overweight, feeling like shit all the time, and regular two day hangovers.

Sure, it helps in the short term. But alcohol puts your body on a rollercoaster of highs and lows, and it is in that oscillation of emotion that anxiety makes itself manifest.

The key is to ration the passion. I can say, without a shadow of a doubt, that Boomtown was by far my most enjoyable drinking experience in a long time, and my body didn’t hate me for it. Now, save for another festival dropping in my lap, I’ve got another eight months ahead of me free of booze while I focus on getting in shape. Once that’s done, I’ll be drinking only when I feel the time is right, and not just for the sake of it.

Of course, alcohol isn’t the only drug we throw at ourselves to cope with anxiety. I’ll discuss some of the illegals in their own posts, but it’s worth noting that cannabis is a drug of choice for many in tackling anxiety, myself included. There’s many things to love about weed. The way it tastes. The more or less instantaneous relaxing impact it has. The way everything becomes suddenly hilarious. But my favourite thing has to be that I can get really worked up over something, smoke a spliff, and suddenly there’s a voice in my head that goes “yeah, well, don’t worry about it”, and then I don’t.

Yet, there’s downsides. Start using it often, and it’ll become a habit. Once a habit, you are relying on a drug to take away your problems. Use it daily, and you won’t get much done. If you aren’t getting anything done apart from smoking weed, your problems will mount up, and they don’t become any less of a problem just because you can’t be arsed to do anything about them.

It’s a similar story for anti-depression and anti-anxiety prescriptions. Valium helps on a day to day basis, yet is increasingly less supplied due to its addictive qualities. Citalopram and other SSRIs effectively build a mental wall between you and your problems, which can help those completely crippled by anxiety get on with their life, but doesn’t provide any quality resolution. Propranolol and other beta-blockers can reduce the physical effects of anxiety, but it’s a drug for angina that comes with a ton of side effects that can actually exacerbate your overall condition.

Simply put, prescription meds are about suppressing the condition, not resolving it. I must note I am coming from a position of bias – all prescribed meds I have taken made my problems ten times worse. But everyone is different. People have different reactions. What hasn’t worked for me may well work for others. Don’t be afraid to try out medications, especially if you are feeling like you are trapped – they may well crack the door open just enough for you to get out the room and get moving.

In looking at coping strategies, you may have also heard about breathing exercises. Before my anxiety peaked, I’d been dabbling with meditation. The whole subject is far too nuanced to sum up in a paragraph, but it’s relatively safe to say that much of it relies on utilising the power of breathing. I was incredibly thankful that I spent some time looking into it when my first panic attack hit. My gut instinct was to crash onto the nearest sofa, and focus all effort into slow, deep breaths which helped me quickly restore some sense of order.

In dealing with anxiety, there’s little that’s more useful in your mental health kitbag than tactics to help you quickly regain control, and breathing exercises are possibly the most impactful. You can use them anywhere. You can use them before an attack to cut it off at the pass, or during an attack to pull yourself back in. You don’t need special training or equipment. It’s as simple as focusing your attention on your breaths, and taking one deep, slow, oxygen rich lungful at a time.

This breathing is central to mindfulness meditation, part of what I consider to be a holy trinity of mindfulness, tai chi, and yoga. While all a little different, the end goal of each is fairly similar: instilling a sense of peace in your daily life. I’m yet to really get the hang of yoga, but find tai chi quite handy, although meditation works best for me. You might try all three and decide none of them are for you, but the key objective here is to find some peace that spills out over into your daily life.

I mentioned The Rock earlier as, although you wouldn’t expect a wrestler to be a fountain of profound knowledge, The Rock knows the score. I saw him once talking about his early morning workouts, and described his gym as his anchor. That one thing he does a day for him. That one thing a day where he can turn off the outside world. A feel good moment of peace you carve out in the day and you can truly relax.

You are unlikely to find it in booze, drugs, and cake. But you can find this in the gym, or in sport. You can find it in yoga. You can find it in fishing, in reading, in doing something creative. It could be comics, it could be practicing magic tricks, it could be carpentry. Whatever it is that you find relaxing, that you can lose yourself in, that you can find passion in. For me, it’s getting on my bike, and in music, in my writing, and in meditation.

In short, something that your body finds relaxing. Something your body doesn’t need cortisol to deal with. Something you love, that makes you feel positive, and that allows you to carry that feeling of love and contentment with you the rest of the day. Reducing the physical stress really is as simple as just being good to yourself, and giving yourself time to enjoy the world around you.

The Rock says find your anchor. So go find it, and lay the smackdown on anxiety.

 

 

Strategies for anxiety – mental

~ Superfluous G ~ 1 Comment

Anxiety requires a multi-pronged approach to loosen its grip. It is both physical and mental, and tackling both are equally important. This post focuses on the mental, and will discuss a few coping strategies. I’m also posting another one alongside it, which focuses on the physical. I’ll be fleshing out the coping strategies over coming posts.

 

Back around 500 BC, Sun Tzu, a Chinese general, wrote The Art of War. The book spans 13 chapters, each focusing on the psychological approaches one should utilise at different parts of a battle: planning, overall strategy, tactics in the battle itself, and so forth. However, Sun Tzu’s strategies can not only be applied actual military battles, but conflict of any kind. Hence why, two and a half millennia later, the book still remains wildly popular with a diverse range of society, ranging from modern militaries to Rage Against the Machine to the coke-addled sociopathic suited human cancers occupying the world’s banking system.

Of Sun Tzu’s various wisdoms, perhaps the most famous is “know your enemy”, or expanded:

“If you know the enemy and know yourself, you need not fear the result of a hundred battles. If you know yourself but not the enemy, for every victory gained you will also suffer a defeat. If you know neither the enemy nor yourself, you will succumb in every battle.”

Typically, I don’t like to describe anxiety as the enemy, or say that I’m battling it, for reasons I’ll make apparent. Yet, for the purpose of this post, let’s treat it as such. So, if we were to approach the problem like Sun Tzu, the most important thing we can do – before anything else – is understand anxiety.

Anxiety is both physical and mental. So to treat it, you have to approach both the physical and the mental aspects at the same time. Without doing anything to reduce the physical stress, your mind will have too much to focus on to apply any real effort to mental unwinding – you’ll just be caught spending your time running between spinning plates. But conversely, if you just ignore the mess in your mind, nothing gets resolved.

As I spoke about in the accompanying post, the body creates cortisol when stressed to help you cope – it can give you increased focus, help you push yourself further, increase your reflexes, all of which can be pretty handy when it comes to jumping out of the way of a car or something similar. With anxiety, because you are stressed all the time, the tap is left on.

The physical symptoms are the result of your body getting burned out from being alert at all times. In turn, you feel burned out, which only feeds your anxiety. As you’ll see, anxiety loves a good circle.

The cortisol itself is produced as part of your body’s fight or flight reaction. Or, more accurately, your fight, flight, or freeze reaction. Many people don’t realise there’s this third option, although a massive chunk of us still do it. When people get taken out of their comfort zone in an emergency, many will freeze. Apparently, playing dead served us well during our evolution.

This whole process is controlled by a part of the brain called the amygdala. This part of the brain is hardwired to the rest of your body – it can react faster than you can think. Whenever you see something coming out of the corner of your eye and duck before you even realise that some mad bastard bird is hurtling towards your face, that’s your amygdala. It identifies threats without consulting you, and takes action before you get a say in the matter. Without it, you’d probably already be dead.

Consequently, the amygdala is a jittery bugger at the best of times. It also has its own memory banks, separate from your own conscious self. Phobias are a good example of this. Rationally, I could absolutely devastate a wasp. It might have a stinger, but I’m a man. A 6’6 man with a variety of swatting tools at arm’s reach. My feet should be tried for war crimes against snails*. I have hands with a surface area that your average fly would find unfathomably terrifying in both scale and raw destructive power. I am the insect world’s Cthulhu.

Yet, all it takes is one wasp to come within a three-metre radius of me, and I completely lose my shit. This is down to my amygdala training itself to fear wasps, and will trigger when any wasp – or any flying insect if it is having a bad day – decides to say hi.

This is why you can panic over seemingly nothing. Think of it like going out with a sober friend while you get trashed. You do all sorts of crazy shit, like stripping off and running through Burger King while telling all the punters to flip your meat. You, of course, conveniently forget all this. Yet, the next day, you walk past Burger King with your friend. Your friend looks concerned, but rather than reminding you of the night before, they just start smacking you with a stick. A big, electrified stick coated in adrenaline. This is your amygdala in action.

Of course, anxiety also exists in the conscious mind, and often works in tandem with the amygdala, in a conversation that I think goes something like this:

“Hey, Amygdala. I’m not liking the situation we’re in. What do you think we should do?”

“I THINK WE SHOULD FREAK THE FUCK OUT!!!”

“Done. I’ll get the oxygen tank, you get the cortisol.”

When combined, the panic can be extremely powerful. You are scared in your conscious mind, and your amygdala is screaming fight, flight, or freeze. Yet, the situation can be as simple as being at work, and punching your boss before legging it out of the office isn’t an option. The fear in your mind battles the rational, and the product is more stress, more cortisol, and more searing holes in your brain where logical reasoning should exist.

The main difference the two processing centres is that in the conscious mind, you are dealing with concepts you can put your finger on. Speaking in front of crowd. Saying the wrong thing in a social setting. Feeling like you are about to drop dead.

All these thoughts work on the same circular principle: a circle of fear. You have triggers – a memory, a sensation, a situation. Your brain jumps to some pre-assumed conclusion. You react in a certain way.

Examples:

I can’t deal with everything. I’m worthless. I’m going to drink.

I can’t think of what to say. No one wants me here. I’m never going to go out.

I’ve been worrying about this lump. I’m obviously about to die. Better have a panic attack.

There can be rational thoughts and fears mixed up here, but you aren’t processing them rationally. Instead, you are just pushing them through the circle of fear. You are allowing past experiences and memories to cloud your ability to find the real truth of the present. Rather than alter your thinking, you are instead re-treading old ground, stomping your way through familiar pathways of fear burned into your brain.

At your core, you are simply reacting to what you see as a truth about yourself. As I spoke about before, deep down, I have a feeling that I’m entirely worthless to anyone, and have allowed my thoughts, feelings, actions, and reactions to be controlled by this concept of myself for the past thirty years.

I’ve sought evidence to support that claim, did little to challenge or overcome it, and dismissed anything to the contrary.

I’m now in the process of overturning all of that. I now know my enemy. It amounts to little more than a simple ingrained thought, and various vicious circles of mental trickery I’ve built to enforce it, with a little help from a meth-addicted crackhead part of my brain that freaks out over things with wings.

Understanding all of this has been a major coping strategy for me. Doing the research into anxiety helps normalise it, rationalise it, and takes away its power. Hit the books, download the podcasts, talk to others about their experience with it. Once you’ve done that, you can begin to apply it.

Talking in of itself is critical. One of the reasons I have this blog is so I can order my thoughts on anxiety, and put a narrative to my experience of it. I can look back over four months of work, and see the progress I’ve made. But it also allows me to be open about it. It shows me that I’m not alone in this.

It works both ways. I’ve had many people get in touch and say this blog has helped them better understand their own anxiety, which is fantastic. But it’s also shown me how other people comprehend it, and that dialogue has shown me ways of thinking about anxiety and life in general that I’d previously not even thought of.

An example of this came the other day while I was doing Cognitive Behavioural Therapy (CBT). I’m currently at week 8 of a 12-week course on it, and have had to change therapists as my first one is off on maternity leave.

I was discussing worthlessness with the new guy, who got me to describe what attributes a worthwhile human being would have. It’s a genuinely tricky question to answer:

“A sense of conviction, the ability to get things done, be productive, to stick to their moral code…” I blurted out.

“You realise that you just described Joseph Stalin, don’t you?”

My sense of worthlessness was shattered. How can I be worthless when what it means to have worth is, in itself, indefinable, ineffable, and entirely subjective?

CBT has delivered a number of similar realisations, and I’d highly encourage people to give it a go. The way it works is to help you identify mental knots in your cognitive thought process and how they affect your behaviours as your behaviours can circle back round into the thought process. Identify the knots, untie them, and then change your approach so you don’t tie them again. It is talking the talk, then walking the walk.

I’ve also found that CBT has a strong synergy with meditation. When you meditate, the goal is to essentially just focus on one thing. This might be your breath, it might be scanning through your body, it can be on a mantra, on a noises surrounding you. It can even be on coffee.

One mindfulness trick is all about coffee. Most of the time, we chug the stuff back while on the move, and pay no attention to it whatsoever. I want you to really taste it. So, next time you order a cappuccino or make a coffee at home, give the experience 100% of your effort. Take note of your surroundings. Listen to it brew. Watch the steam as it pours. Smell it as the impending caffeine hits your nostrils. Sip slowly, and spend time identifying exactly what you taste. You will be in awe at what happens when you pay attention.

Of course, your mind will wander while doing it. This happens all the time when you meditate. You are trying to achieve complete stillness of the mind, but this is next to impossible. Therein lies the fun.

What you are training your brain to do is to notice thoughts as they happen, to not react to them, and to be able to let them go. It’s the gym for your brain. You are building a muscle that can keep you in the present, identifying thoughts as they come in, and happily give them the finger as they drift back off into the cerebral oblivion of your subconscious.

Combine that with CBT, and what you’ve got is a deeper understanding of yourself and the sort of bullshit your idiot brain likes to throw at you, and an effective countermeasure to it. It’s the understanding, the strategy, the tactics, and the army all wrapped up. It’s about as Sun Tzu as it can get.

But here’s why it’s not a battle, and anxiety isn’t the enemy. In knowing anxiety, you come to know yourself. You see yourself from different perspectives, and gain a greater understanding of yourself. What you fear. Why you act the way you do. You are the enemy of which Tzu spoke of. Knowing the enemy is knowing yourself.

But in that knowledge of yourself, you find peace. You aren’t your own enemy. In understanding, you realise that there’s no reason to fight yourself. You are just a human being just like the rest of us, with all the faults any of us have, with a silly human brain that’s just doing its best to keep you away from fear, harm, and wasps.

 

*To any snails reading this, I am so, so sorry. Know that I never meant to hurt a single one of you. Slugs, on the other hand, can fuck right off.