Understand, overcome and break free from worry and anxiety Bestselling personal development author, Gill Hasson is back and this time she's here to help with something that affects everyone at some point in their life, Anxiety. Worries and anxieties are familiar to us all. Worrying can be helpful when it prompts you to take action and solve a problem but unrelenting doubts, fears, and negative possibilities can dominate your mind, affect your ability to manage your everyday life and wellbeing, your sleep and appetite, your social life, and your ability to concentrate. But it doesn't need to be like this, there are ways that you can manage this spiral of unhelpful thoughts and difficult feelings. Overcoming Anxiety explains how to manage anxiety and stop it from taking over; it teaches you the skills you need to lead a more peaceful, stress-free life. Overcoming Anxiety: * Provides practical strategies and techniques to manage your anxiety * Discusses how to break free from negative cycles and move forward in a positive way * Contains real-life examples from anxiety sufferers * Explores what it takes to handle immediate anxiety events and longer term, low-level 'background' anxiety and worry About the Author Gill Hasson is the bestselling author of the Mindfulness Pocketbook, Mindfulness, How to Deal with Difficult People and Emotional Intelligence. Gill teaches adult education courses in personal development and is an Associate Tutor for the University of Sussex where she teaches career, personal development and academic study skills. Gill is also a freelance journalist and writes articles on personal development and relationships for a variety of magazines, including Psychologies and Take A Break, and for a number of websites.
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This edition first published 2016
© 2016 Gill Hasson
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Library of Congress Cataloging-in-Publication Data
Hasson, Gill, author. Overcoming anxiety : reassuring ways to break free from stress and worry and lead a calmer life / Gill Hasson. pages cm Includes index. ISBN 978-0-85708-630-3 (pbk.) 1. Anxiety. 2. Stress management. I. Title. BF575.A6H37 2016 152.4’6—dc23
A catalogue record for this book is available from the British Library.
ISBN 978-0-857-08630-3 (pbk) ISBN 978-0-857-08632-7 (ebk) ISBN 978-0-857-08631-0 (ebk)
Cover design: Wiley
Introduction: The Age of Anxiety
Part One: Understanding Anxiety
1 The Three Aspects of Anxiety
Self-sustaining nature of anxiety
Nature or nurture?
In a nutshell
2 Understanding Your Own Anxiety
Generalized Anxiety Disorder (GAD)
Obsessive Compulsive Disorder (OCD)
Irritable bowel syndrome (IBS)
In a nutshell
3 Understanding the Way You Think
The way you think
Self-talk and cognitive distortions
Becoming more aware of your thoughts
In a nutshell
Part Two: Managing Anxiety
4 Changing the Way You Think
Challenging your self-talk
Replacing negative self-talk and cognitive distortions with positive self-talk
Take control of your brain
Making positive self-talk a habit
Frame your thoughts in positive words and language
Changing the way you think
In a nutshell
5 Taking a Mindful Approach
Awareness, acceptance, acknowledgement, non-judgement and letting go
Beginner’s mind, focus, engagement and patience
Acceptance and Commitment Therapy
In a nutshell
6 Managing What You Do
How/why worry and anxiety affect your body
In a nutshell
7 Using Solution-Based Problem Solving
Solution-focused problem solving
In a nutshell
8 Boosting Your Confidence, Courage and Assertiveness
Start from a position of strength
In a nutshell
9 Finding Help and Support from Others
Reach out and help other people
How family and friends can help you
Finding a balance between being supportive and enabling
In a nutshell
Other Useful Resources
About the Author
Table of Contents
‘A horrible dread at the pit of my stomach … a sense of the insecurity of life.’
William James Hall
Over the last few years, I’ve learnt a lot about anxiety from people who come on the personal development courses and workshops I run. Increasingly, it seems that more and more people are struggling with anxiety; they describe how – in varying degrees – anxiety has affected and disrupted their lives.
Anxiety affects all of us in one way or another. You don’t have to be diagnosed with an anxiety disorder to feel its intrusive, debilitating effects.
I grew up with anxiety – my Mum has been anxious all her life. There was always something she was anxious about. As soon as one anxiety was over, another would take its place. My Dad, sister and I managed Mum and her anxiety as best we could.
Fortunately, I haven’t inherited my mother’s persistent anxiety, but in my 20s and 30s I suffered from panic attacks. They seemed to come from nowhere. They also went away for no apparent reason. It wasn’t until they went away that I even knew there was a name for them.
The Mental Health Foundation (the UK’s leading mental health research, policy and service improvement charity) suggests that anxiety is one of the most prevalent mental health problems in the UK and elsewhere, yet it is still under-reported, under-diagnosed and under-treated.
A survey of 2,330 people in the UK carried out in 2014 by YouGov for the Mental Health Foundation revealed that almost one in five people feel anxious ‘nearly all of the time’ or ‘a lot of the time’.
The Mental Health Foundation’s report ‘Living with Anxiety’ showed that worries concerning financial issues, the welfare of children and family members, and work issues are the main factors contributing to high levels of anxiety in everyday life.
The report also highlighted the following findings:
Who gets anxious:
Women are more likely to feel anxious than men.
Students, young people and people not in employment are more likely to feel anxious all of the time or a lot of the time.
Just under half of people get more anxious these days than they used to and believe that anxiety has stopped them from doing things in their life.
What people get anxious about:
Financial issues are a cause of anxiety for half of people, but this is less likely to be the case for older people.
Women and older people are more likely to feel anxious about the welfare of loved ones.
Four in every ten employed people experience anxiety about their work.
Around a fifth of people who are anxious have a fear of unemployment.
Younger people are much more likely to feel anxious about personal relationships.
Older people are more likely to be anxious about growing old, the death of a loved one and their own death.
The youngest people surveyed (aged 18–24) were twice as likely to be anxious about being alone than the oldest people (aged over 55 years).
How people cope with anxiety:
Fewer than one in ten people have sought help from their doctor to deal with anxiety, although those who feel anxious more frequently are much more likely to do this.
The most commonly used coping strategies are talking to a friend, going for a walk and physical exercise.
Comfort eating is used by a quarter of people to cope with feelings of anxiety; women and young people are more likely to use this as a way of coping.
A third of the students in the survey said they cope by ‘hiding themselves away from the world’.
People who are unemployed are more likely to use coping strategies that are potentially harmful, such as alcohol and cigarettes.
Attitudes towards anxiety:
More than a quarter of people felt that feeling anxious was a sign of not being able to cope.
But 50% disagreed and nearly three-quarters (74%) of people said anxiety was not something to be ashamed of.
‘The Age of Anxiety’ appears to be defined by the pressures and uncertainties of modern life. However, the Mental Health Foundation’s report concludes that ‘anxiety stems as much from concern for family, friends and relationships as it does from the demands of the outside world.’ The bottom line is that people can experience anxiety, and anxiety disorders, related to just about anything.
Everyone gets nervous or anxious from time to time – when speaking in public, for instance, or when going through financial difficulty. For some people, however, anxiety becomes so frequent, or so forceful, that it begins to take over their lives.
The majority of anxiety sufferers are able to function on a day-to-day basis – albeit with difficulty. But it is possible to worry so much that it starts to have a noticeable impact on your daily life.
Anxiety can make you feel on edge, irritable and unable to relax or concentrate. The way you think can be affected: if you fear that the worst is going to happen, you may start to see everything negatively and become very pessimistic. You may feel the need to frequently seek the reassurance of others. You may experience physical symptoms – headaches and nausea, for example.
To cope with these feelings and sensations, you may turn to smoking or drinking too much, or misusing drugs. You may hold on to relationships that either encourage your anxious outlook or help you avoid situations you find distressing – and so stop you dealing with what’s worrying you.
You may withdraw from social contact and also find going to work difficult and stressful; you may take time off sick.
If your anxiety is severe, you may find it difficult to hold down a job, develop or maintain good relationships. Sleep problems may make your anxious feelings even worse and reduce your ability to cope.
For some people, anxiety becomes so overwhelming that it takes over their lives and can cause long-term mental health problems.
Whether you have occasional anxiety or a diagnosable disorder, the good news is that you can take effective and straightforward steps every day to manage and minimize your anxiety.
Things can be changed for the better; there’s plenty you can do to understand and help yourself. This book will show you how.
Some people find it really helpful to understand what anxiety is; others just want to know what to do about it – they want advice, tips and techniques. This book does both.
The chapters in Part 1 explain exactly what anxiety is and how it can present itself – as generalized anxiety disorder, as panic attacks, phobias, OCD and/or IBS.
You will learn that anxiety manifests itself in three different ways: in the way you think, how you physically feel and the way you behave. Part 1 also explains how your thoughts, feelings and behaviour affect each other. You will also be encouraged to question and challenge negative and anxious thoughts, as well as to learn how to replace negative thoughts with more helpful, realistic ways of thinking.
In Part 2, Chapters 4 and 5 explain how to manage the cognitive aspect of anxiety: your thoughts, beliefs and expectations. Chapter 5 introduces you to ways you can use mindfulness to manage anxiety.
It can, though, feel impossible to think clearly when you’re flooded with anxiety. You may need to calm down physically first. Chapter 6 explains ways that you can manage the physical feelings that come with anxiety.
Chapter 7 encourages you to focus on what you can change, rather than aspects of the situation that are beyond your control. You will learn how to find one small step you can take now and discover that once you start doing something – something constructive – you may feel less worried because you are moving beyond worry and doubt and doing something about it.
You will also learn how to identify activities that you can turn to when you want to switch off from worrying; something that you can dip into for ten minutes or immerse yourself in for an hour. Something that keeps you focused and engaged, that brings your complete attention to the present experience.
In Chapter 8 you will read about the role of courage, confidence and self-esteem in relation to managing anxiety. There are plenty of ideas, tips and techniques to help you assert yourself so that you are less anxious about dealing with other people.
Finally, Chapter 9 looks at the importance of reaching out to and connecting with other people. It explains what friends and family need to know, what you can ask them to do and how they can help. This final chapter also introduces the idea that other people in your life, despite their good intentions, might, without realizing it, be enabling and supporting your anxiety.
You will find some other useful support and general resources at the back of the book.
Throughout the book, there are quotes and examples from other people who have experienced anxiety. You will read about their ways of managing and overcoming their worries, anxieties and fears in a range of situations – at work, at home and in social situations.
Also throughout the book, there are exercises, activities and tips, strategies and techniques for you to try. However, not every tip, technique or strategy works the same for everyone and every anxious experience. What is crucial is that you learn and develop a range of techniques and strategies that work for you. Some of the tips and techniques you pick up will bring quick results. Others – like learning to accept or change the way you think – will take time and practice.
You’ve got to work at it to identify ways to manage your anxiety that work for you – and keep at it. Yes, it can be tedious, boring and hard work, but anxiety can be those things too. Learning to manage anxiety is much more positive than being controlled by anxiety!
Who hasn’t, at one time or another, been worried or anxious?
We’ve all experienced doubts, fears and worries; most of us have experienced feeling tense, uncertain and even fearful at the thought of speaking to a group or sitting an exam, having an operation, attending an interview or starting a new job.
Maybe right now you’re worried about a forthcoming social event or driving somewhere new on your own. Perhaps you get anxious when your partner or teenager is late home. If everything goes well – your partner or teenager arrives home, the social event or the journey has been and gone – the anxiety will go with it, but until it is over, the hours, days or weeks leading up to it can be very difficult.
Perhaps you’re worried about losing your job or something dreadful happening to your partner or children. You may be anxious about events that feel like they’re beyond your control: being attacked, being made redundant or never being able to own your own home. Perhaps you fret about global warming or getting cancer.
Whatever it is that’s worrying you and making you anxious, it can have an effect on both your body and your mind. Anxiety can leave you feeling uncomfortable or even physically unwell. It can be an annoying distraction or it can leave you unable to think about anything else whatsoever.
Anxiety can erode your confidence and self-esteem, affect your relationships and friendships and impair your ability to study and work. If, for whatever reason, you experience prolonged or intense anxiety, you may find it difficult to deal with in your everyday life; you may feel powerless and out of control.
‘Sometimes, anxiety takes over my life – I find myself worrying about everything, even small things like my son forgetting his PE kit become an overwhelming concern.’
After a while, you may start to fear the symptoms of anxiety and this can set up a vicious circle. You may be anxious because you dread the feelings of anxiety, but then you experience those symptoms because you’re having anxious thoughts. You feel that something bad will or might happen and you don’t know how or if you will be able to cope.
Anxiety is the anticipation of trouble, misfortune or adversity, difficulties or disaster. If you haven’t any experience of an event or situation, you may be anxious about what could happen or how you will cope with it. But if you have experienced a particular situation and you found it difficult or distressing in some way, you may be anxious about facing a similar situation again in case it brings up the same challenges and difficulties.
Is there a difference between anxiety and fear, worry and doubt? Doubt happens when you feel uncertain about something: you think it’s unlikely that something will turn out well. Worry concerns feelings of unease and feeling troubled. Fear is a reaction to immediate danger – your car going into a skid, for example, or a child running into the road – whereas anxiety involves a response to something farther away in the future: something that’s going to happen later today, tomorrow, next week and so on. It could be, for example, an interview, a plane flight or speaking up at a meeting. You could be feeling anxious but you don’t know what exactly you’re anxious about.
Whether it’s fear, anxiety, worry or doubt, the feelings are very much the same. Why? Why does anxiety so often have such a debilitating effect? It helps to understand what, exactly, anxiety is.
Just like fear, worry and doubt, anxiety is an emotion. Emotions cause us to feel, think and act in different ways: they can cause us to do something or avoid doing something.
All emotions, including anxiety, have a positive intent: worrying and feeling anxious about doing well before an exam or giving a presentation, for example, can prompt you to prepare well and keep you alert and focused. However, like all other emotions, anxiety becomes a problem if, instead of prompting you to respond in a way that’s helpful, it overwhelms or paralyses you. In the example of exams, if anxiety takes over, your stomach may be in knots, your heart thumps and negative thoughts can dominate your mind. Your ability to revise, think straight and concentrate suffers.
It’s not, though, just how and what you think that can make you anxious. Again, just like all other emotions, anxiety has three parts: physical feelings, thoughts and behaviour. Let’s look at each of these aspects more closely.
This part of anxiety involves the physical changes that occur in your body – the internal bodily changes you experience.
Some of the most common physical symptoms of anxiety are:
Muscle tension, which can cause headaches, tension in your jaw, neck and shoulder pain or tightness in your throat and chest.
Rapid breathing, which may make you feel weak, light-headed and shaky, and may give you pins and needles in your fingers and toes.
Rising blood pressure, which can make you more aware of a pounding heart.
A rush of hormones, which can give you hot flushes and make you sweat.
Changes in the blood supply to your digestive system, which may cause ‘butterflies’, nausea and sickness.
Frequent visits to the loo.
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