How can the symptoms of anxiety be reduced and managed?

There are many ways that a person with an anxiety disorder can reduce the symptoms and manage their illness.

Postpone major life changes

• When feeling stressed or anxious, it's not a good idea to move house or change jobs. Leave changes to a time when things are a little less stressful.
  

Take part in enjoyable activities

• People with anxiety disorders spend a lot of time worrying. Part of maintaining a balanced life means putting aside time to do enjoyable things such as exercising, meditating, reading, gardening or listening to music. For more information see beyondblue Fact Sheet 8 - Keeping active.
  

Resolve personal conflicts

• Stress in personal relationships is one of the most common causes of mental health problems. Talking to a counsellor or psychologist can help a person with an anxiety disorder to find ways of addressing problems.
  

Keep work under control

• A person with an anxiety disorder should try to take control of their work situation by avoiding long hours and additional responsibilities. This may be difficult to achieve, but small changes can make a difference. Learning to say ‘No’ more often can help create a balance between work and play. It can reduce the chances of people with anxiety disorders becoming overwhelmed.
  

Seek help

• Talking to a trusted friend, doctor or counsellor can help to relieve stress. Asking for help and support at home, at work or in other activities can also reduce stress. For more information click on this link for the types of help available http://beyondblue.org.au/index.aspx?link_id=90.621&tmp=FileDownload&fid=324
  

Support groups provide an opportunity for people with anxiety disorders to discuss their common problems and find ways of dealing with them. There are also support groups for families and friends of people with anxiety disorders. Please visit our links page.

Practise breathing and muscle relaxation techniques

Stress can affect how a person breathes and can cause muscle tension. Breathing quickly and having tense muscles can, in turn, make a person feel more stressed. This vicious cycle can be stopped by learning and practising breathing and muscle relaxation techniques. Relaxation exercises help people to recognise the symptoms of anxiety and use specific relaxation techniques to feel less anxious.

For more details see beyondblue Fact Sheet 6 - Reducing stress. http://beyondblue.org.au/index.aspx?link_id=90.621&tmp=FileDownload&fid=326. For more information on alternative treatments see beyondblue Fact Sheet 14 - Other treatments for depression and anxiety. http://beyondblue.org.au/index.aspx?link_id=90.621&tmp=FileDownload&fid=331

Do some research

Gather information on anxiety disorders from sources such as the internet, audio/videotapes and books. This may help people to understand anxiety better and cope with it.

Establish good sleeping patterns

Having a good night's sleep is important for maintaining good health. The body needs the opportunity to recharge from the day's activities. Anxiety can cause sleep disturbances such as:

•  Difficulty getting to sleep
  
•  Not having a deep sleep
  
•  Waking very early in the morning and not being able to get back to sleep.
  

This can make symptoms of anxiety disorders worse e.g. irritability, feeling edgy, overwhelmed and tired. There are a number of things that can improve sleep patterns including:

In the morning …

• The person should get out of bed as soon as they wake up. Don't go back to sleep or try to make up for ‘lost sleep’.
  
• Try to get up at about the same time each morning, perhaps around 7am to 7.30am.
  
•  Go outside into the fresh air.
  
• Do some physical activity e.g. go for a walk.
  

During the day…

•     Don't take naps. Napping makes people less tired when they go to bed at night and makes it harder to fall asleep.
  
•     Deal with worries by setting aside some time for problem-solving during the day.
  
•     Identify problems that are causing stress and think about how to solve them.
  
•     Keep a sleep-wake diary.
  
•     Review sleep-wake patterns with a doctor at each visit.
  
•     During the day, try to be physically active.
  
•     Avoid drinking caffeine after 4pm and try not to drink more than two cups of caffeine-type drinks each day e.g. coffee, strong tea, cola or energy drinks.
  

Before going to bed …

•  Avoid going to bed too early - it isn't the right time for deep sleep.
  
•  Go to bed at a similar time each night - around 10pm to 10:30pm.
  
•  Avoid using alcohol to help fall asleep. When alcohol is broken down in the body, it causes people to sleep less deeply and to wake more frequently.
  
•  Don't smoke within an hour or two of going to bed. Smoking stimulates the nervous system.
  
• Don't go to bed hungry or with a full bladder.
  
• Regular exercise can improve sleep, but avoid vigorous exercise late in the evening.
  
• Allow time to wind down before going to bed - stop working, studying or exercising at least 30 minutes before bedtime.
  
• Use the bed only for sleep and sex so that it becomes associated with sleep.
  
• Avoid taking sleeping pills for longer than a week because they can be addictive.
  

While sleeping …

•  Make the bedroom quiet, dim and a comfortable temperature.
  
•  Avoid too many blankets and electric blankets - being too hot can make it harder to fall asleep or stay in a deep sleep.
  

Overcome long-term sleeping problems …

• Get up if you can't fall asleep. Staying in bed when you're feeling restless and anxious is unlikely to result in sleep.
  
• Doing something to take your mind off trying to get to sleep e.g. play cards, read, knit, watch TV or enjoy a warm bath. Being distracted from worries makes it easier to wind down and become sleepy.
  
• Go back to bed when more relaxed and sleepy.
  
• Before going to bed, do relaxation exercises like deep breathing techniques.
  

Keep active

Exercise is important for maintaining both good physical health and mental health.

Some tips for keeping active:

Plan - A person with an anxiety disorder should make a plan, so they plan some enjoyable activities every day and finish each day with a sense of achievement.

Start small and build up slowly - If a person is going through a period of anxiety, they may have difficulty with simple things like getting dressed in the morning and getting out of the house. The person shouldn't try to do too much too early. It's a good idea to start with easy tasks/activities and slowly build on them.

Include other people - When people don't feel like doing much, having a plan in place for outings or social activities can help get them moving.

Don't be too hard on yourself - Sticking to a schedule can be a challenge. It's only a rough guide and should be flexible. If an activity runs overtime or can't be completed, skip it and move onto the next one at the appointed time.

Reward yourself - Allow time to do enjoyable, interesting, relaxing and satisfying activities. Some cheap, entertaining, enjoyable pastimes include reading, listening to music, watching movies, gardening, going to the beach or park, taking part in sporting or creative activities, shopping, seeing friends or playing with pets.

Exercise physiologists are people who have an understanding of how exercising affects the body and mind. They can help people get motivated, develop an individual exercise plan and stay on track. Their fee may be subsidised by Medicare. For more information see our links to external organisations page.

For more information see beyondblue Fact Sheet 8 - Keeping active. http://beyondblue.org.au/index.aspx?link_id=90.621&tmp=FileDownload&fid=328

Reducing alcohol and other drugs

• Many people treat their mood problems by drinking alcohol, smoking tobacco and cannabis and taking other drugs.
  
• Although these substances may provide temporary relief, they can cause long-term problems.
  
• Most illegal drugs and alcohol interfere with the effects of medication. If a person has been consuming large amounts of alcohol or other drugs, it's important they tell their doctor so an appropriate treatment plan can be worked out.
  
• People often find it difficult to stop cigarette smoking and may need to seek advice from a health professional.
  
• For more information see beyondblue Fact Sheet 9 - Reducing alcohol and other drugs. http://beyondblue.org.au/index.aspx?link_id=90.621&tmp=FileDownload&fid=329
  

Anxiety and result from many reasons.  The triggers to the anxiety attack must be addressed.  From a natural therapy point I would use homoeopathic remedies that have been wonderful in relaxing and calming the mind along with herbal formulas and meditation.  Meditation is excellent for helping with all states of anxiousness and mood fluctuations.  Bowen therapy is also very good at helping people who experience anxiety since it frees up stagnant chi energy like acupuncture which can affect the state of the mind.  Creative visualisation is a powerful meditattive technique that allows the person to use the power of their mind and like hypnotherapy helps with underlying fears, lessening the intensity.

Slow breathing down

Just to put a bit of a different idea out there - it might be worth doing a bit of an experiment to see what happens when you actually do less to control or get rid of anxiety. I know that may sound strange and the last thing you naturally want to do - and yet does it seem to fit with your experience that when you try desperately to get rid of anxiety that it actually gets worse???? That certainly is what happens to me and many other people I have spoken to. 

For example, the sensations that someone gets when they have a “panic attack” are the body's natural response to a perceived danger. Sometimes there isn't really a threat but our mind thinks there is as this is an old pattern that our minds have been doing for 1000s of years!! This is called the “flight or fight” response. And panic attacks are not uncommon at times when we are very stressed or have been sick. If someone has this experience and then freaks out (as it is pretty unpleasant and may seem to have happened out of the blue) then it is likely that they will get more and more anxious and may actually start to get quite anxious about getting anxious. Does that make sense? Soon they may become so fearful of getting anxious that they unfortunately end up getting a lot more anxious than they were before - and more anxious than the person who has the one off panic and just sees it perhaps as a sign that they are stressed, their body is telling them to slow down or similar. 

If you want to learn more about these sort of ideas you might like to read more about Acceptance and Commitment Therapy (ACT), an approach to dealing with problems such as anxiety, depression, stress (and lots of other issues you may face) that can help you to learn more effective ways to handle difficult thoughts and feelings such as anxiety so that you can get on with doing more of the things that matter to you!

Go to www.contextualpsychology.org to learn more!

I have been using focusing to help clients reduce and manage anxiety. Focusing was “discovered” by Gendlin and can be facilitated in partnership with a therapist and clients can also use it as a self help practice. Focusing begins with a mindfulness meditation but goes further in turning attention to a felt sense in the body. As a first step in reducing and managing feelings of anxiety clients focus on where in the body they sense these feelings and to practice describing these feelings as “something in me”. To no longer identify these feelings with “I”  is a crucial first step in not being overwhelmed by feelings of anxiety. This provides a space of freedom to observe these feelings and realise they are not all of you. 

Learning a combination of ACT, CBT and breathing exercises (thanks to my clinical psychologist) has helped me to deal with my relatively rare episodes of anxiety.

Bowen Therapy is very effective at reducing the symptoms of anxiety.  The gentle, non-invasive moves stimulate the brain to relax muscle groups.  After a few moves, the therapist allows the body time to absorb the messages and respond at its own pace (usually a couple of minustes).  After a treatment drink plenty of water to hydrate the fascia layer and take gentle exercise.