Anxiety and Relapse Prevention (Part 2)

Anxiety for many can be a disabling experience and, can make a person imagine that things in their life are a lot worse than they actually are, and in some cases increase feelings of paranoia. As I mentioned in my previous article in Part 1, some people have an identifiable cause for their anxiety, i.e. near death of a loved one. However, others do not have an identifiable cause for their anxiety, which can increase levels of distress. As a therapist I am constantly drawing parallels between the psychological, physical and behavioural symptoms of anxiety. Below are some examples:

Common physical symptoms of anxiety -

• Increased heart rate/ palpitations

• Hyperventilation/ Shortness of breath

• Dizziness/ Shaking

• Nausea/ Increased bowel movements

• Increased perspiration/hot flushes/ sweaty palms

Common psychological symptoms of anxiety -

• Paranoia/ hypochondriac behaviour 

• Feeling detached from your environment

• Wanting to run away/ escape from a situation

• Thinking you're losing control/ losing your mind

Once you have experienced these symptoms, and are aware of your 'warning signs' (refer to previous article) you can 'self - monitor' by using a daily ratings scale, i.e. 0 could mean no anxiety, and 10 could be high anxiety. This indicates how you're managing your anxiety. You can then assess if you need to increase or decrease certain activities. This would be best done in advance. For example,
'When I notice I am avoiding situations, I need to do something before it worsens'.

Devise an 'emergency plan' which may involve a therapist or mental health practitioner. For example, tackle avoidance, contact people who are supportive, ask for help and most of all be honest with yourself.

Preventative Factors/ Strategies 

'If I had no structure to my day, I felt more anxious. Now I try to plan one enjoyable event, each day, that I can focus on'

Preventative Factors, only become effective when they are learned and practiced. Some of the activities listed below, are often events that people easily do, but it is not until they experience an anxiety disorder, that they realise activities neglected. 

Preventative Strategies can include

• Diary writing - keeping a journal.

• Cognitive restructuring, using positive affirmations.

• Diet - eating well, excessive use of stimulants such as caffeine, sugar, alcohol can exacerbate anxiety, palpitations, sweating and breathing irregularities.

• Exercise - helps to burn off adrenaline, that will reduce the physical symptoms of anxiety.

• Medication - Consulting your GP, for medical advice to reduce anxiety.

• Relaxation Techniques - reading, reiki, meditation, yoga etc.

I cannot manage my Anxiety alone

Often help is needed to manage anxiety symptoms. Keeping family/ friends informed about your feelings, can be a supportive network, to identify relapses, warning signs etc. There are also other sources - 

Self-help groups
GP/ Community Primary Care services/ Psychiatry (chronic and severe anxiety)
Counselling - aims to help the client explore problems and discover coping strategies and utilises a non-directive approach.
CBT - identifies moods, emotions, thinking and behaviours, developing practical techniques used in therapy.

Develop a knowledge base, learn everything you can about your anxiety and the treatments that are available to you. Keep your work/ life balance in check, engage in social activity (which may be as simple as meeting a friend for a coffee) as self imposed isolation increases a relapse. Focus on the present, as opposed to negative events of the past. Address what is going well, instead of revolving around the problem; relapses can be learned from. Using a relapse prevention plan, which you can modify and adapt, helps to avoid further relapses. Recovery is a process, but by identifying 'tools' that have worked in the past, will help you, with potential triggers/ warning signs to prevent a future relapse. By taking autonomy over your condition, will enable you to make informed choices, increasing positive anxiety management.