Anxiety and Relapse Prevention (Part 1)

Anxiety can affect anyone, at any stage of their lives; the awkward adolescent troubled by Social Anxiety Disorder; the father traumatised by a road traffic accident, resulting in Panic Attacks or the commuter overwhelmed by Claustrophobia, whilst travelling on an overcrowded bus or train. As a former Disability Living Allowance Advisor, I recall the numerous anxious clients I spoke to, who feared walking outdoors unaccompanied, due to being a victim of crime, or struggling with debilitating physical ill health. Whilst other clients were stressed out with family/work demands and the impact of Irritable Bowel Syndrome. There are many forms of chronic and severe anxiety, but this two part article is centred around Generalised Anxiety Disorder, triggers and relapse prevention.

What is a Relapse?

A relapse is an increase in unhelpful thinking and behaviours, resulting in difficulties with coping with day to day activities. Stress increased symptoms of panic or negative thoughts, can occur for a variety of reasons, such as the anniversary of a bereavement, marital discord, moving home, conflict at work etc. These specific events can lead to anxiety, panic or negative thinking, often called 'triggers' Some 'triggers' occur without conscious awareness,(unaware of the psychological impact of an event) but by creating your awareness, you will be able to prepare yourself and manage these events more skilfully, reducing the potentials of a relapse, severe anxiety and depression.

Identifying the needs for change

Identifying change is a cognitive approach - looking at ways in which you think, feel and act, during a period of anxiety, and comparing it to how you feel, when you've experienced better mental health. It might be useful to ask yourself the following questions -

• What are the changes/differences in the way I handle practical situations, relationships, work, finances?

• How can I apply this to my future/ new skills learned?

• How can I apply these tools to my everyday life? 

Identifying barriers/ obstacles

Once you have identified the actions, thoughts and behaviours that have helped you to make changes, what is it that prevents you from continuing them? There are those affected by generalised anxiety disorders, who engage in self-defeating, self-sabotaging negative thought patterns, which can become a self-fulfilling prophecy - a repetitive cycle with negative thoughts leading to negative behaviour. Ask yourself the following questions -

• What behaviours/ thoughts do you conduct that are unhelpful? e.g. 'When I set myself unrealistic goals, I know that I am setting myself up for failure'.

• What potential situations or people, are unhelpful? e.g. 'When I'm feeling anxious, I will visit my family. They always tell me to 'snap out of it' and this only makes me feel worse'.

Even if you have tried various coping mechanisms, there are other symptoms indicative of a relapse. Here are examples of possible signs - (this list is not exhaustive)

Altered sleeping patters - getting less sleep, waking up in the middle of the night, or difficulty waking up in the morning.

Change in mood - lack of motivation/overeating/overspending, excessive use of stimulants drugs, alcohol, caffeine etc.

Changes in behaviour - withdrawal from social contact and activities you would normally enjoy/ reduced libido/ increased insecurity, needing reassurance for tasks that you ordinarily perform confidently/ lack of concentration, wandering thought patterns, easily distracted etc.

Of all these warning signs of relapse, one most prevalent in anxiety disorder is avoidance. If you cannot face a situation, the easiest way out is to avoid it. But rather than avoid a situation, person or event, try and face it, and do the opposite of what your anxiety is telling you to do - which will reduce your anxiety in the long run.

However if you have been diagnosed by your doctor for Agoraphobia, Obsessive Compulsive DIsorder, Post Traumatic Stress Disorder, or a specific phobia it is likely that you would be referred to a Psychiatrist, for a comprehensive assessment.

In my second article, I will be looking at ways in which you can monitor, your anxiety levels on a day to day basis, addressing preventative factors/strategies and resources available to you, i.e. 1-1 counselling to enable you to manage your anxiety more effectively.