Self Help for Anxiety
- Do you find that you spend large periods of the day worrying?
- Do you often feel nervous, apprehensive or on edge?
- Do you feel that things are getting on top of you?
- Do you find it hard to relax and ‘switch off’?
- Do you often experience unpleasant physical sensations such as ‘butterflies’ in your stomach, muscular tension, dizziness or breathlessness?
If the answer to any of these questions is ‘yes,’ you may be experiencing symptoms of anxiety and you may find this helpful.
- Recognise whether you may be experiencing symptoms of anxiety.
- Understand what anxiety is, what causes it and what keeps it going.
- Find ways to understand, manage or overcome your anxiety.
Do I have symptoms of anxiety?
If you experience symptoms of anxiety it is likely that you will recognise many of the feelings, physical symptoms, thoughts and behaviour patterns described below.
Irritable/low patience threshold
Tense body/Muscular pain
Chest tight or painful
Trembling or tingling sensations
Breathing faster or slower than usual
You often worry ‘what if’ something bad happens
Your mind jumps from worry to worry
You often imagine the worst case scenarios
You are always on the look out for danger
Avoid doing things you would like to
Pace around/Find it hard to relax
Snap at people too easily
Get easily flustered
Talk very quickly
If you have ticked a number of these boxes you may be experiencing symptoms of anxiety. However don’t be alarmed, this is very common and there are things you can do to improve your situation. You will find some useful strategies in this workbook.
What is anxiety?
Anxiety is an unpleasant feeling that we all experience at times. It is a word often used to describe when we feel ‘uptight’, ‘irritable’, ‘nervous’, ‘tense’, or ‘wound up’. When we are anxious we normally experience a variety of uncomfortable physical sensations. These include:
- Increased heart rate
- Muscular tension
- Feelings of breathlessness
As well as this, anxiety affects us mentally too. For example, when anxious, we often worry for large periods of time, so much so that our worry can feel out of control. These worries are often about a variety of issues and commonly our mind jumps quickly from one worry to another.
Anxiety also influences how we behave. For instance, when we feel anxious, we often avoid doing things that we want to because we are worried about how they will turn out. Although short experiences of anxiety are part and parcel of daily life, it becomes challenging when anxiety begins to follow people around and is a regular feature in their lives.
What causes anxiety?
Often we develop anxiety following a series of stressful life events. This is especially true if we experience many different pressures all at once. For example, if someone has work pressures, financial difficulties, and relationship problems, all at the same time, it is perhaps unsurprising that they become anxious. When thinking about it in this way, anxiety is often the result of feeling as though we cannot cope with the demands placed upon us.
In addition, people can learn to be anxious based on their life experiences. For example, if someone has faced workplace bullying in the past, they may be more likely to suffer anxiety when beginning a new job.
Some people may have a thinking style that lends itself to experiencing anxiety. For example, anxious people have a tendency to expect that the worst possible scenario will always occur. They also feel like they must constantly be on guard in case something bad happens. They believe that by thinking about all the things that could go wrong, they will be better prepared to cope if it happens. However thinking in these ways mean they are on regular alert and find it difficult to relax and ‘switch off’.
We also experience anxiety because of its evolutionary benefits. Put another way, although anxiety is largely an unpleasant experience, it also has positive benefits that have been useful to humans over the centuries. For example, when we are under threat or feel in danger (e.g. hear a burglar), we automatically become anxious. As a result, our heart beats more quickly which supplies blood to our muscles (which helps us run away from or fight the burglar); we sweat (which cools us down during this process); and our breathing changes (which ensures oxygen is delivered to our muscles quickly again preparing us for a quick response). When looking at anxiety in this way, you can quickly see how it can be very useful in certain situations.
It has also been suggested that anxiety has familial ties. In other words, if someone in your immediate family is an anxious person, there is an increased chance that you will have similar personality traits.
In reality it is likely that a combination of all these factors influence someone’s anxiety levels. However, in some ways it is less important to know what causes anxiety, and more important to know what stops us overcoming it.
What keeps our anxiety going?
Some people have a style of thinking which lends itself to experiencing anxiety. For example, it appears that some people are more likely to overestimate the likelihood of bad things happening than others. It is easy to see how regularly presuming the worst in this way would make someone feel anxious. Unfortunately, when we do feel anxious, we become even less likely to think as clearly as we would like and a vicious cycle occurs.
Anxious people also sometimes believe that worrying has a protective function. More specifically, they believe that being on the ‘look out’ for danger can help them to recognise and avoid it. Unfortunately, when searching for danger in this way, they soon begin seeing potential danger in many relatively safe situations which of course makes them feel anxious. They may also believe that by considering everything that could go wrong; they will be better prepared to cope when it does. However, often these beliefs mean a lot of extra time is spent worrying than is necessary, as many of our worries never come true. Of course, the more time we spend worrying, the more anxious we feel.
Another way someone’s thinking style can keep their anxiety going is because they become ‘worried about worrying’. Here, people tend to worry that they are doing harm to themselves (e.g. going mad) by worrying so often (which is not the case) and a vicious cycle occurs. Similarly, people often worry about the physical symptoms they experience when they are anxious (e.g. breathlessness, rapid heart rate etc). Unfortunately, worrying about these symptoms (which are perfectly safe and natural bodily reactions), only makes them feel worse, again creating a vicious cycle of anxiety.
One other important factor that can keep people’s anxiety going is that they often change their behaviour as a result of their anxiety. For example, they may avoid going to a party because they have spotted many potential ‘dangers’ (e.g. what if no one likes me). Similarly, they may put off completing an assignment because they worry about it being negatively evaluated. Unfortunately because people tend to use such avoidance strategies, they can never see that things would often go better than they thought and their anxiety remains as a result.
Not having enough free time to relax and do the things we enjoy we can also contribute to our higher anxiety levels. On the other hand, having too much free time can mean we have lots of opportunities to engage in worry and feel anxious.
When looking more closely at anxiety, you can begin to see that our thoughts, feelings, behaviours and physical symptoms all interact and combine to keep our anxiety going.
How can I reduce my anxiety?
Fortunately, there are a number of strategies that we can use to reduce our anxiety. These include:
- Understanding more about anxiety.
- Learning how to challenge your unhelpful thoughts and see things in a more realistic light.
- Improving your problem solving skills.
- Learning how to reduce the amount of time you spend worrying.
- Learning how you can feel more relaxed (physically and mentally).
- Learning how to stop avoiding the things that make you anxious.
When going through this booklet it can sometimes be more helpful to try out the ideas above one at a time, rather and trying to learn them all at once. However simply take things at your own pace.
Anxiety is undoubtedly an unpleasant feeling, but it is something that everyone experiences. Of course, some people experience anxiety more regularly than others, but it is a completely natural experience that is part and parcel of daily life. Due to the unpleasant nature of anxiety, people often worry that experiencing it is harmful. For example they may fear that regularly worrying will make them go mad or that the physical symptoms of anxiety (e.g. heart racing) are signs of a serious health problem. Such fears naturally make people even more anxious which creates a vicious cycle of anxiety.
However, when exploring anxiety more closely, we can see that it is a very healthy response which actually helps to protect us. By learning more about anxiety and why we experience it in the first place, we can see that it is not harmful. This can help us to be less fearful of the symptoms which in turn has a positive affect on our overall anxiety levels. If however you are concerned that some of your symptoms are not caused by anxiety, contact your GP if necessary.
The symptoms we experience when anxious are often referred to as the ‘fight or flight’ response. This comes from the idea that people primarily experience anxiety to help them either fight or run away from danger. For example, if you saw a burglar, two options open to you would be to either – fight them off (fight) or try to run away (flight). Our fight or flight response would kick in to help us at this point. For example:
- Our hearts would begin beating more quickly (supplying blood to our muscles).
- We would sweat (to cool us down).
- Our muscles would become tense (ready for action).
- We would take deeper breaths (to supply oxygen to our muscles).
In essence, all of these responses would aid our escape or improve our ability to stay and fight the intruder. When considered in this way, we can see how the symptoms of anxiety are helpful to us. Indeed, all of the physical symptoms we experience when anxious play a helpful role in protecting us in such circumstances.
This fight or flight response was likely even more vital to human survival back in the days of early man, when people had to hunt for their food and were under a greater threat from predators. Nowadays we do not face the same threats, but unfortunately, our bodies and minds have not caught up with these changes. As a result, we now experience anxiety in situations where it is not necessarily as helpful because we cannot fight or run away from them (e.g. work or financial pressures). However, the one thing that has stayed true is the fact that these symptoms are not dangerous; it is in many ways the right response but at the wrong time. Remembering this can help you to be less fearful of the symptoms of anxiety which will allow them to pass sooner.
Challenging unhelpful thoughts
The way that we think about things has an impact on our anxiety levels. Many of these thoughts occur outside of our control, and can be negative or unhelpful. It is therefore important to remember that they are just thoughts, without any real basis, and are not necessarily facts. Even though we may believe a lot of our unhelpful thoughts when we are anxious, it is good to remember that they should be questioned as they are often based on wrong assumptions.
The following section will help you begin to recognise if you are thinking about things in an unhelpful or unrealistic way, and discuss how you can start to make changes to this. By doing so, you can learn to see things in a more realistic light which can help to reduce your anxiety levels. You might have unhelpful thoughts about all kinds of things. Here are some examples:
Being judged negatively by others:
- They think I’m useless
- They won’t like me
Being unable to cope:
- I’ll make a fool of myself
- I’m too anxious to manage that
- I’ll have a panic attack
Something terrible happening:
- What if I have an accident?
- What if I lose my job?
It is clear to see how this kind of thinking might make us anxious. Do you ever think in any of the ways outlined above?
You might find it difficult to identify an unhelpful thought. Try thinking about a time when you were feeling anxious. Consider what was running through your mind at that time.
Patterns of unhelpful thinking
First you need to be able to recognise an unhelpful thought. Then you can challenge it. Being aware of the common patterns that unhelpful thoughts follow can help you to recognise when you have them. Here are some of the common patterns that our unhelpful thoughts follow:
Predicting the Future:
When we are feeling anxious, it is common for us to spend a lot of time thinking about the future and predicting what could go wrong, rather than just letting things be. In the end most of our predictions don’t happen and we have wasted time and energy being worried and upset about them. For example:
- Assuming you will perform poorly at your job interview.
- Spending the week before an exam predicting you will fail, despite all your hard work studying and your previous good grades.
This means that you make assumptions about others’ beliefs without having any real evidence to support them. For example:
- My boss thinks I’m stupid.
- People think I’m weird.
Such ways of thinking naturally make us apprehensive.
People commonly ‘catastrophise’ when they are anxious, which basically means that they often blow things out of proportion. For example:
- They assume that something that has happened is far worse than it really is (e.g. that their friend is going to dislike them because they cancelled a night out).
- They may think that something terrible is going to happen in the future, when, in reality, there is very little evidence to support it (e.g. I’m going to get into serious trouble for calling in sick).
Focusing on the Negatives:
Anxious people often have a tendency to focus on the negatives which keeps their anxiety going. For example:
- They focus on the one person at work who doesn’t like them, ignoring that they are very popular with the rest of their colleagues.
People often imagine how they would like things to be or how they ‘should be’ rather than accepting how things really are. For example:
- I should have got an A in History.
- I should never be anxious.
Unfortunately when we do this, we are simply applying extra pressure to ourselves that can result in anxiety. Instead it can sometimes help to accept that things can’t always be perfect.
Based on one isolated incident you assume that all others will follow a similar pattern in the future. For example:
- When enrolling on a college course, you meet a future classmate who you find irritating. As a result, you worry that everyone in the class will be the same and you won’t make any friends.
What If Statements:
Have you ever wondered “what if” something bad happens? For example:
- What if I have a panic attack at the party?
- What if I don’t make friends when I start my new job?
This type of thought can often make us avoid going places or doing the things that we would like.
Do you find that you attach negative labels to yourself? For example:
- I’m weak.
- I’m a waste of space.
- I’m always anxious.
Labels like these really influence how we see ourselves and can heighten our anxiety levels.
We can learn techniques to challenge these unhelpful thoughts. This can help to reduce your anxiety levels. The next part of this handout will discuss how we can go about challenging our unhelpful thoughts. You may come up with a more balanced thought that is accurate and based on evidence.
How to challenge unhelpful thoughts
Once you have recognised an unhelpful thought the next stage is to challenge it. To do this, you can ask yourself a serious of questions.
Challenges to an unhelpful thought
Now you can challenge your unhelpful thoughts by asking these questions.
Is there any evidence that contradicts this thought?
- I’ve always done well in my previous exams.
- I’ve been scoring well in my coursework.
Can you identify any of the patterns of unhelpful thinking described earlier?
- I’m ‘predicting the future’. I have no evidence to suggest I’ll fail.
What would you say to a friend who had this thought in a similar situation?
- I’d say don’t be silly, you’ve always done well. As long as you’ve studied hard, you should be fine. Besides, you can only try your best.
What are the costs and benefits of thinking in this way?
- Costs: It’s making me feel sick with worry.
- Benefits: I can’t really think of any.
How will you feel about this in 6 months time?
- I’ll probably look back and laugh about how silly I was being.
Is there another way of looking at this situation?
- I’ve always done well in the past so I should be ok. I can only do my best anyway; after all I’ve studied hard. At worst, I’ll just have to re-sit next year.
Once you have asked yourself these questions, you should read through your answers. Try to come up with a more balanced or rational view. For example:
Worrying about failing is doing me no good. I’ve always done well before so I should be fine, especially since I’ve prepared properly.
Try to apply these questions to the unhelpful thoughts that you notice. It can help to reduce your anxiety levels.
You might find it more difficult to cope if you have lots of problems that you can’t seem to get on top of. This can have a clear impact on our anxiety levels. Struggling with unresolved problems can often make us feel worse. We can end up worrying or ruminating over our problems without finding a way to resolve them. This can make us feel even more upset, and can end up interfering with our sleep.
It can help to develop a structured way of working through a problem. Beginning to overcome some of your problems might help you to feel better. You can improve your problem solving skills by learning to apply the steps outlined here.
Identify your problem
The first thing to ask yourself is “what is the problem?” Try to be as specific as possible. For example:
- “I owe 400 to my friend.”
- “I am going to miss this deadline.”
Come up with possible solutions
Try to list every way that you can think to overcome your problem. Don’t worry about how unrealistic an idea seems. Write down anything and everything. The best solutions are likely to be the ones you think of yourself. This is because nobody really knows your situation as well as you do. It may help to consider:
- How you might have solved similar problems in the past.
- What your friends or family would advise.
- How you would like to see yourself tackling the problem.
Choose a solution
Next you need to select the best solution from your list. Think carefully about each option. It is useful to go through all the reasons ‘for’ and ‘against’ each idea. This will help you to make a good decision and select the best solution.
After this you may find that you are still unsure. Perhaps a couple of approaches seem equally good. Try to pick one to begin with. If it doesn’t work then you can always go back and try out a different one later.
Break down your solution
To help you carry out your chosen solution, it can be useful to break it down into smaller steps. This can make it easier and more manageable to follow through. The number of steps required will vary depending on the solution and how complex it is. For example: Someone with debt may have decided to try and resolve their problem by getting a part time job. This would require several steps.
- Buying a newspaper with job adverts.
- Choosing which jobs to apply for.
- Creating a CV.
- Sending out their CV.
- Buying interview clothes.
- Preparing answers to potential interview questions.
Try out your solution and review the outcome
Follow the steps required to carry out your solution. Simply take them one at a time. Go at your own pace and don’t allow yourself to feel too rushed.
Once you have completed all the steps, you should then review the outcome. If you have successfully resolved your problem then great. If the problem still exists then don’t give up.
- Is there another solution on your list that you could try?
- Is there a different solution that you have yet to consider?
- Can you ask someone else if they have any ideas or advice?
- Can you combine any of your solutions?
It is useful to remember that not all problems are within our control. This can make it really difficult if not impossible to resolve using the steps above. Perhaps you will have to wait, or ask someone else to take action instead. In such a situation, try not to worry. Nothing can be gained from worrying about something that you have no control over.