Anxiety

So many people complain that they worry about everything. And if they have nothing to worry about they worry that they are missing something that they should be worried about. It feels as though their thoughts have a life of their own and nothing stops them.

Does anxiety come with trauma? Often yes. Traumatic events often remove safety. They let us know the unthinkable can happen. We have always known bad things can happen, but we did not really think they would happen to us. When they do, the belief we had that there is safety in the world is shattered.

There are a few ways we can show our loss of safety in the world. Common forms are: generalised anxiety disorder, panic attacks and simple phobias. In children, separation anxiety can sometimes result following traumatic events.

I’m going to mention the symptoms and give some idea on how they are treated. It is generally helpful to consult a psychologist if you are struggling. If they are concerned, they may speak to your general practitioner regarding medication or if necessary refer you to a psychiatrist.

In generalised anxiety disorder one of the main symptoms is worrying. We find ourselves worrying about all that can go wrong. And despite our best efforts we can’t stop the worry. Other symptoms include tiredness, difficulty falling asleep or restless sleep, muscle aches, poor concentration and you may find you are irritable.Typically the worrying thoughts are not things we have much control over and the “overthinking” does not solve the problem. We do need to distinguish and if it is something we can do something about, we need to do that and not concern ourselves with our thoughts. For example: If I’m worrying about finances, but I have not drawn up a budget, explored ways to manage my finances better, I must go and deal with my financial problems. But, if I have done what I can, and cannot stop worrying about my finances, even though there is nothing more I can do regarding it, it is time to learn how to manage my thoughts.

As you will have realised, trying to stop yourself from worrying does not work. It can actually appear to worsen the problem. Obeying the need to worry and spending time being pulled into the concerns also does not work. xxLet’s demonstrate how hard it is to stop thoughts. Under no circumstances, work hard at it, refuse to see the pink mouse under your chair. And the more determined you are to not see the little pink mouse, the greater the chance that you will see him.
There are some other techniques you can try. You can try and postpone your thoughts instead. We can all postpone thoughts and often have. You are sitting and worrying about something and suddenly your phone rings. It’s someone important to you. You quickly ask yourself: shall I answer the phone or worry? And you quickly decide, to answer the phone and worry about your issue later.

Let’s use that ability to your advantage. When you realise you may be worrying, ask yourself whether more pondering will solve the problem. If yes, think a bit more and do what you need to do. If not, recognise that you are worrying. Decide to postpone your thinking and worry about it a bit later. Give yourself a time, e.g. at three this afternoon I’ll worry for fifteen minutes. Then go and do something else. When three comes, if you remember, you can worry for fifteen minutes. If you don’t have the need or forget, you just go on with your life.

Another option is to make space for the worry. Allow it to be there, like a radio playing in the background, while you focus on something else. I have added the reference to a booklet from the WHO which explains this technique in more detail.
Do such a simple techniques work? Surprisingly well. You need to practise it. Studies inform us that with practise, up to four out five of people find they have seventy to eighty per cent relief. It’s not hard and it is probably worth trying.

There are some other techniques you can try. You can try and postpone your thoughts instead. We can all postpone thoughts and often have. You are sitting and worrying about something and suddenly your phone rings. It’s someone important to you. You quickly ask yourself: shall I answer the phone or worry? And you quickly decide, to answer the phone and worry about your issue later.

Do such a simple techniques work? Surprisingly well. You need to practise it. Studies inform us that with practise, up to four out five of people find they have seventy to eighty per cent relief. It’s not hard and it is probably worth trying.

As you will notice, even though we may suspect you have developed the anxiety because of the trauma you have gone through, managing it means you need to develop skills which help you to focus on things that are more important than repetitively thinking about your concerns.

The Second Coming
By William Butler Yeats
Turning and turning in the widening gyre
The falcon cannot hear the falconer;
Things fall apart; the centre cannot hold;
Mere anarchy is loosed upon the world,
The blood-dimmed tide is loosed, and everywhere
The ceremony of innocence is drowned;
The best lack all conviction, while the worst
Are full of passionate intensity.

What Kind of Times Are These
By Adrienne Rich
I've walked there picking mushrooms at the edge of dread, but don't be fooled
this isn't a Russian poem, this is not somewhere else but here,
our country moving closer to its own truth and dread,
its own ways of making people disappear.

Panic attacks are very common following a traumatic event. They accompany another diagnosis, such as PTSD or Major Depression. Panic attacks can manifest with a long list of symptoms, but the main experience is a period of intense fear. Other symptoms include things like an increased heart rate, fear that you are going to die or go crazy or lose control. You could find yourself shaking, feeling that you can’t breathe or that you are choking. Chest pain is not uncommon and you could feel very hot or cold. You might feel nauseous, dizzy or have pins and needles in your hands or feet or they might feel numb. You might feel you are disconnected from everything or feel that things are unreal, As you can see, you feel as though you are out of control and that there is something wrong with your body.

The first time you experience these symptoms, please check them out with your doctor.

Panic attacks can sometimes be so scary that people will start doing less and less in their lives in order to avoid having them. For example, if you had a panic attack in a mall, you may start avoiding malls or crowded places.

How are panic attacks treated? As you have probably discovered, avoiding triggering a panic attack worsens the impact they have on your life. It’s as though you give them more power over you. This makes sense if you think it through. Let’s assume you are avoiding crowded places and every time you go to the mall you have a panic attack. By not going, you feel some relief. That rewards your avoidant behaviour. You start avoiding more and more situation where you could possibly trigger a panic attack. To treat panic attacks we often confront the symptoms. People who have had panic attacks become over-sensitive to body sensations that remind them of what they experienced during a panic attack. They then react in fear or startle when they feel a similar sensation. This seems to precipitate a panic attack. In treatment, we try and get you used to the sensations that you associate with a panic attack. Once they no longer startle you, it becomes much easier to manage what you feel and often the panic attacks stop. This is known as interoceptive exposure. You can ask your psychologist to help you overcome panic attacks.

This refers to being irrationally afraid of something. Examples include animals, insects, closed spaces, and so on. There are numerous things or situations that people can develop a fear of. On occasion these fears are linked to traumatic events. A typical example is a fear of driving following a terrible motor vehicle accident.

As you may guess, avoidance worsens the impact of the fear and it can sometimes generalise to other related activities or objects. Treatment usually involved exposure. If a traumatic event underlies it, it may be useful to first treat the memory of the event before doing exposure exercises. The exposure is generally done as a hierarchy. We start with less frightening moving to more frightening. Staying with driving. We may start with simply sitting in the car for a pre-determined time. We will then move to slightly more frightening and repeat the process as many times as we need to. We end with most frightening, for example driving at night in the rain on a freeway.