It is very common when someone becomes anxious for changes to occur in their breathing. They can begin to gulp air, thinking that they are going to suffocate, or can begin to breathe really quickly. This has the effect of making them feel dizzy and therefore more anxious. This is called over-breathing, or hyper-ventilation.
Try to recognise if you are doing this and slow your breathing down. Getting into a regular rhythm of in two-three and out two-three will soon return your breathing to normal. Some people find it helpful to use the second hand of a watch to time their breathing. Other people have found breathing into a paper bag or cupped hands helpful. For this to work you must cover your nose and mouth.
It usually takes at least three minutes of slow breathing or breathing into a bag for your breathing to return to normal.
If you take your mind off your symptoms you will find that the symptoms often disappear. Try to look around you. Study things in detail, car registration numbers, what sort of shoes people are wearing, conversations etc. Again, you need to distract yourself for at least three minutes before your symptoms will begin to reduce.
Whilst relaxation, breathing exercises and distraction techniques can help reduce anxiety it is vital to realise that anxiety is not harmful or dangerous. Even if we did not use these techniques, nothing awful would happen. Anxiety cannot harm us, but it can be uncomfortable. These techniques can help reduce this discomfort.
3. Altering your thoughts related to anxiety
We have seen the role that thoughts have in keeping going the vicious cycle of anxiety. Sometimes there may also be pictures in your mind. To give an example, imagine you are running for a bus one day. All of a sudden you get a pain in your chest and feel really breathless. The thought goes through your mind, "I'm having a heart attack". This thought is, of course, very frightening, and so your heart starts to beat faster, which makes you think "there really must be something wrong with my heart". You may very well have a picture of the ambulance on its way and you on a stretcher.
It isn't always that simple to know what you are thinking that is making your anxiety worse. The sort of thoughts that make people anxious can come and go in a flash, and may be so much of a habit that they are automatic. They may be so familiar that they just feel like part of you.
As mentioned before, try to keep a diary over the course of two weeks or longer. Write down your own thoughts in situations where you are anxious. Now, try to imagine the last time you felt very anxious. Try to run through it like a film, in as much detail as you can. See if you can write down any frightening thoughts now. Remember any thoughts can count. No thought is too small or too silly. Even 'oh no' or 'here we go again' can raise tension and anxiety. Some thoughts are like unpleasant pictures in your mind.
Once you know what it is you are thinking, you can begin to fight back, and break the vicious cycle. In particular, ask yourself:
- Am i exaggerating, example - 'everything is bound to go wrong, it always does'.
- Am i jumping to conclusions, example- 'i have a pain in my chest therefore it must be my heart'.
- Am i focusing on the bad things, example - 'i had a really bad day yesterday' (ignoring that this followed a few good days).
Use these questions to assist yourself answer back. A good way of doing this is to write two columns - one for your thoughts that make you anxious, and the other for a more balance thought, example:
1.ANXIOUS THOUGHT - The dizzy feeling means i'm going to faint.
A.BALANCED THOUGHT- I have had it many times before and have not fainted. I have fainted once and that felt really different.
2.ANXIOUS THOUGHT- I'm going mad and insane.
B.BALANCED THOUGHT- I have not gone mad yet, and the doctor tells me anxiety is not madness.
Write down some of your thoughts now and write as many answers as you can. This question might also help. What would you say to a friend who was thinking that way? The aim is to get faster a "catching" these anxious thoughts and answering back almost instantly. It takes a lot of practice, but really does work if you persevere.
4. Changing your behaviours related to anxiety
- Try to recognise when you are avoiding things and wherever possible try to tackle these fears, not all at once but in a gradual way.
- Set yourself very small goals. Write down on your diary goals that you would like to tackle. Start with the easiest first and tick off any activity you achieve. You may want to draw a two column table like the one above of your own to set out your goals.
- People often get into the habit of escaping from situations that make them anxious. Instead of escaping try gradually to increase how long you stay in a situation that makes you anxious. Anxiety often reaches a peak, then starts to go away naturally. If you stay in an anxious situation what do you predict will happen to your anxiety? People often think it will just keep getting worse and worse. This is not the case. It will start to come down.
- People not only avoid situations and try to escape, they also often do things to make themselves feel safer, example - hanging on to a shopping trolley, lying down. These 'safety behaviours' may help at the time, but they also help to keep the anxiety going because the anxious person never learns that nothing awful would have happened even if the trolley wasn't there. Also, imagine how frightening it would be if no trolley was available.
- Try to do things to test out whether your anxious thoughts are realistic, example - 'would i really faint if i didn't get out'?
It really is vitally important to recognise that the more you avoid something, the more difficult it will seem to overcome, which will in turn make you more anxious.