I want to address a mental health condition that I struggle with on daily basis. I have generalized anxiety disorder along with my diagnosis of major depression. One mental illness is tough to deal with. Having two mental illnesses is even more challenging. There are a few different anxiety disorders. My focus in this blog will be on generalized anxiety disorder (GAD), but while each disorder has its specific characteristics and symptoms, there is overlap between the disorders.
What is anxiety? The American Psychological Association defines anxiety as “an emotion characterized by apprehension and somatic symptoms of tension in which an individual anticipates impending danger, catastrophe, or misfortune.” Anxiety is more than just fear. We all feel anxiety at times in our lives. Work, illness, or school are examples of things that can cause us to feel anxiety. The difference for a person with an anxiety disorder is that the anxiety does not go away, and it can worsen over time. Anxiety disorders often interfere with daily living. For a person with generalized anxiety disorder, anxiety is ongoing. It is frequent and lasts for months or years.
My anxiety reared its ugly head when I was about 20 years old and has persisted for over 30 years. There are times when it is worse than others. I have learned coping strategies, but sometimes those are not enough. Generalized anxiety disorder interrupts my life. It also embarrasses me. I do not like others to see my anxiety. Unfortunately, it is difficult to hide.
According to SAMHSA (Substance Abuse and Mental Health Services Administration) the symptoms of generalized anxiety disorder include: a sense of restlessness, being on-edge or wound up, difficulty concentrating, irritability, being easily fatigued, headaches, muscle aches, stomachaches, or unexplained pains, trouble thinking, difficulty controlling feelings of worry, and sweating, nausea, or diarrhea. That is quite a list. Can you imagine living with those symptoms? Unfortunately, I live with many of these symptoms.
My anxiety has been worse than usual lately. It hit a peak last week. In my experience anxiety ebbs and flows. There are times when I am doing well and able to cope with the anxiety. Other times, I struggle and often need help. So, what helps anxiety?
There are medications that can alleviate some of the anxiety experienced by people with generalized anxiety disorder. Since I am not a doctor, I do not want to discuss medication. One reason is that I do not want there to be an appearance of supporting a particular medication. Another reason is that medication has not been entirely helpful for me. I will leave discussions about anxiety medication to the medical experts. I am an expert in living with anxiety, but I am not a doctor. Lived experience is different than medical expertise.
Let’s look at coping strategies and non-medication approaches. We can break down anxiety coping strategies into a few categories: immediate “in-the-moment” techniques, mental and cognitive skills, lifestyle and behavioral approaches, and long-term support. As we go through these strategies, keep in mind that not all of them work for everyone. It is necessary to try different strategies and see what works for you. Do not just stop at one. It is important to have a bag of coping strategies to rely on.
Five strategies can be considered immediate “in-the-moment” techniques. Deep breathing can help calm anxiety. Try inhaling slowly for a count of four, hold the breath for four counts, and exhale for a count of six. This helps calm the autonomic nervous system. Another strategy is the 5-4-3-2-1 grounding method. First, identify five things you can see. Then identify four things you can touch. Next, identify three things you can hear. Then identify two things you can smell. Finally, identify one thing you can taste. The intent of this strategy is to shift the focus of from your anxiety to the present moment. A similar coping strategy is the 3-3-3 rule. In this strategy you name three things you see, three sounds you hear, and move three parts of your body. Another strategy is the cold-water splash. Washing your face with cold water triggers a reflex that instantly lowers your heart rate. A strategy that I find helpful is progressive muscle relaxation (PMR). In this strategy you tense and release different muscle groups stating from the toes to the head, and then release the physical tension. Sometimes I incorporate this strategy into self-hypnosis. When I do this, I usually go in the opposite direction and start with my face and move toward my toes.
There are four mental and cognitive skills that can help with anxiety. Cognitive reframing is when you challenge anxious thoughts by asking if they are based on evidence. Then replacing the anxious thoughts with a more balanced perspective. This can take practice. It might be helpful to write down different perspectives that focus on countering anxious thoughts. Practice reading them when you are not anxious to help commit them to memory so that it might be easier to retrieve them when you are anxious. Another strategy is brain dumping or journaling. In this strategy you write down anxious thoughts to help with processing emotions and gaining perspectives. This is a strategy that I find helpful, especially in the earlier stages of anxiety. Often, I need to use one of the immediate “in-the-moment” strategies first if my anxiety has reached a more intense level. Then I can work through my anxious thoughts in writing. A third strategy in this category is distraction/occupying the mind. When using this strategy try to engage in puzzles, counting, or reading to shift the focus away from racing thoughts. Another strategy that can be helpful is using positive affirmations. You can select a few positive, calming affirmations and then repeat these words to reassure yourself.
A third category of anxiety coping strategies is lifestyle and behavioral approaches. Engaging in physical exercise can help ease anxiety. Daily activity such as walking, yoga, or running reduces endorphins and can reduce stress. Prioritizing sleep hygiene can be helpful. Try to get 7-9 hours of sleep. When we are fatigued, anxiety can increase. So, getting adequate sleep can be helpful. It is important to limit stimulants. We need to reduce the amount of caffeine and/or alcohol we intake. These can trigger or worsen panic and anxiety symptoms. Social connection can also help reduce anxiety. Talking to a trusted friend or family member can help us ease our anxiety. This is especially true if this person is familiar with how anxiety affects you and knows your coping strategies. I have found this to be an important part of how I deal with anxiety.
Finally, long-term support is important. This includes professional therapy. It is important that we do not try to deal with anxiety on our own. When we have an anxiety disorder, we need to recognize that it is an illness. This means we need help from professionals trained to work with people living with anxiety disorders. I talk to my psychologist and psychiatrist about my anxiety frequently. I have a team of mental health professionals I can reach out to when I am struggling. I think it is important that we develop support systems like this. We might also join a support group. There are different support groups available. You can ask your mental health professional for recommendations. You can also join NAMI Connections. This is a peer led support group through NAMI (National Alliance on Mental Illness). Another long-term strategy is mindfulness or meditation. Practicing these can help us observe anxious thoughts without judgement. This can help us work through our anxiety.
Other strategies I have tried include using a weighted blanket and a weighted stuffed animal. There is research that indicates that a weighted blanket can help ease anxiety. I find it helpful. The weight feels soothing for me and as it soothes me, I find that I a m able to slow my thoughts. Engaging in art or listening to music might be helpful for some people. Maybe some of you reading this have found success with other strategies. I encourage you to share your strategies in the comments section.
Anxiety can be debilitating. I continue to struggle with anxiety. My strategies useful and I know when I need to reach out for help. It is important that we acknowledge that anxiety is a legitimate health disorder. We are not overreacting. We are not weak. Anxiety is real. So, if you struggle with anxiety, try some of the above strategies and reach out for help. If you do not have a mental health professional, I encourage you to talk to your primary care provider. This provider can refer you to a mental health professional.
We can live with anxiety disorders. It requires us to work at overcoming anxiety. It is important to remember that we are not our anxiety. With the right help and the use of coping strategies we can develop the ability to work through our anxiety. If you struggle with anxiety, please remember that you are not alone and there is help.
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