Wednesday 15 July 2015

Anxiety (Part 2) and My experience with anxiety (part 1)

Anxiety (part 2)

In this blog post today, I am going to talk about my experience with anxiety and how it affected my life when I was first diagnosed with an anxiety disorder.

My experience

I didn't realise I had an anxiety disorder until 2 years ago when I started sixth form. I remember the first symptom of anxiety that I had was pain to my chest and stabbing pains to my heart as well as heart palpitations (Irregular/fast heart beat). I didn't know why I was experiencing this symptom because at the time I wasn't diagnosed with anxiety and I didn't know what was happening to me. I thought it could have been a heart attack but it wasn't. I had this constant pain to my chest and heart for a month. After my first anxiety attack, I dreaded of having another one but the next day it happened to me again. They became frequent. Every time after experiencing anxiety attacks, I became really tired and my body ached all over from trying to calm myself down for 10-20 minutes. At the time, I didn't know that I was experiencing anxiety attacks.

A few months down the line, I experienced having insomnia (trouble sleeping and staying asleep at night), I think it was due to the fact of worrying about school and coursework. I just kept on tossing and turning all night long which made it very hard for me to wake up eventually when I fell to sleep in the early hours of the morning. Some nights it was worse than others as it made me feel very nauseous (stomach cramps, vomiting and diarrhoea). I admit that is the worst to have when you have an anxiety disorder as I was in bed for days before attempting to get myself up and over to the doctors. It started to experience this once or twice a week to the extreme. It got to the point where one day I was sleep and all of a sudden I became paralysed. I couldn't move a single limb. My vision went all blurred. This really scared me. Then one day I was sat in bed and I just became paralysed again. At first I thought it was sleep paralysis but it couldn't be because I experienced it when I was wake. It got to the point where I kept it all in that it made me break down at school. I was called into the sixth form mentor to tell her how I felt and she recommended going to Number One Councilling. I called them up but I didn't hear anything from them in a month.

A few weeks later, at school I started to hear voices calling my name but when I turned around and asked someone if they called me, they said no. I was really creeped out and I thought I was going crazy. All of a sudden when I was walking home from school one day, I experienced a really terrifying hallucination that made me think twice. I told my mum about this and at first she thought I had schizophrenia. This is when I realised that I had to go and see a doctor as soon as I can so that I could get myself checked out and see what was wrong with me. The first time that I went to the doctors about it, they said that I was exaggerating which made me feel like I was going crazy.

I started experiencing the majority of the symptoms of anxiety, this was a warning sign that I had to go over the doctors and fully get diagnosed with anxiety. I saw the doctor and told him about my experience and symptoms I have been happening and he turned around and said that it seems to me that you have been experiencing anxiety attacks. You should stay calm when you have an anxiety attack, I know it is hard but you will get used to telling your mind that you aren't going to be harmed from it and to ignore it. I tried my best to tell my mind this every day that I had an anxiety attack. The anxiety attacks became more frequent and it got to the point where I couldn't deal with it anymore. I started to experience more hallucinations so I booked myself another doctors appointment and they told me the same as what they said the last time I went there. They said that they wanted me to book myself in for a blood test for the following week so I did. They didn't find anything in my blood that could have been causing these hallucinations. The doctor gave me some questionnaires to fill in for anxiety and depression and it seemed that my anxiety levels and depression levels were really high as my mood was low and I experienced the symptoms of anxiety. Therefore they referred to Talking Therapies.

My Talking Therapies experience

It took Talking Therapies around a 3 weeks to get back to me and I booked myself in for a 1 to 1 session on the phone. When I had my 1 to 1 session on the phone, they asked me to rate my symptoms and feelings from 1-10 and how often these occurred. They then asked me if I wanted to do 1 to 1 sessions on the phone or attend a group session where I could gain more of an understanding of anxiety and depression and I said a group session so that I could learn more about anxiety and depression, why I was feeling like I was and how to deal  with anxiety and anxiety attacks. They booked me in for a 6 week group appointment on a Wednesday evening.

The first week that I attended this session, I wasn't very keen on being in a group session because I felt like everyone was more confident than what I was but I carried it on so that I could learn ways to deal with anxiety and depression. In the first session, I learned about CBT (Cognitive Behavioral Therapy). This is where I had to think of a trigger/situation and I had to identify my thoughts, feelings, physical sensations and behavior. This was what I called the hot cross bun method. By doing this activity, it gave me more of an understanding of why I was feeling like I was.

In the second session, I still felt uncomfortable but I started to get to know the people in the group who I could relate to by the way we were feeling and thinking. I didn't feel alone anymore as I knew that I wasn't the only one who was suffering from anxiety and depression. In this session, I learned about unhelpful behaviors in low mood (depression). I got to learn about the vicious cycle and what happens when you are in a low mood. This session gave me to gain knowledge about depression and know why I was feeling how I was feeling and things that would make you feel worse. For example: A depressed mood leads to negative thoughts which then leads to reduced activity (social interaction) which then leads to loss of positive rewards and the cycle keeps on going round and round. This cycle makes us feel worse and therefore we may avoid important and necessary activities which can have a large impact on our lifes. We went on to talking about the depressive spiral how feeling depressed will make you engage in fewer interactions with positive outcomes. This will make you feel more depressed which leads to you becoming less socially active and then you will feel more depressed which you will do even less for ourselves or with others. This shows when your mood is low, we find ourselves engaging in unhelpful behaviours. These unhelpful behaviours can lead to new problems or worsening the existing problems which leads to a further reduction in mood.

In session three, I began to feel more comfortable and I came out of my shell. I began to share my thoughts and feelings with the group of people around me and understand more about anxiety and worrying. In this session, I learned about worry. This was good as this was what I needed to work on and find out how to deal with worry. This session gave me more of an understanding of what worrying is and how it can affect people with anxiety disorders. As I suffer with anxiety and worry a lot about everything, this gave me a chance to understand why some people worry more than people. This made me feel like I am normal because worrying too much causes different symptoms. From this session I learned that everyone experiences worry from time to time when we are faced with difficult or uncertain situations. However some people worry a lot to the point that it begins to affect their wellbeing and causes chronic feelings of nervousness, stress and anxiety. I also learned that worry is a type of self talk in which we predict that negative events will happen in the future and we over-estimate the possibility of disaster. Worrying thoughts tend to be characterized by 'what if?' statements. These statements could be: 'What if my plane is delayed?', 'what if I'm caught in traffic and I am late for work?', 'what if something awful happens?', 'what if I get ill?' and 'what if I lose my job?'. These are imagined situations in which we try to plan how we would cope with these events if they were to happen. This involves over-estimating the likelihood or severity of negative events and underestimating our own ability to cope, if the event did occur. Another thing that I learned in this session was about real worry and hypothetical worry. Real worries are worries that are centre on a real life problem or current problem that needs to be resolved. With real worry, we are often trying to solve the problem by worrying about it, running through different scenarios and strategies in our minds in the hope of finding a solution. However, hypothetical worries are worries that may never happen, and which we have no control of influence over. This worry is usually thought of excessively which can be very difficult to stop once it gains momentum. This leaves us feeling anxious, nervous and tense. We then did an activity where we had to list down themes that make us worried and identify whether they are a real or a hypothetical worry. This made me more aware if my worries are ones that exist or worries about things that may not happen. I found out that the majority of my worries are hypothetical from this session.

Then, in the same session we went on to talking about the role of uncertainty. We had to think about things that we worry about and think if we would be worried if these worries are completely certain. I learned that worrying tends to be about future events which certainty is impossible. I also learned that worrying is a reaction to uncertainty and people who worry a lot tend to have a low tolerance of uncertainty. Even a small amount of uncertainty can cause worry. I learned that intolerance of uncertainty leads fuels to worry which then generates worry further. Another thing learned about is what keeps worrying going? And the reason behind it is that worrying is maintained by unhelpful ways of thinking and behaving. We then looked at identifying potentially unhelpful behaviours and then looked at how to get more control of our thinking. I learned that in worrying, our behaviours are altered. This is because we could be trying to achieve certainty by finding out more information, or putting off making decisions until we can be absolutely certain that we will make the right decision.

Here is a list of unhelpful strategies that I learned about in this session:
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- Looking for lots of information:
  • Looking for lots of information to help us come to a decision only increases the uncertainty and triggers more worry.
  • The additional information does not necessarily make things clearer but just gives us more information to consider and worry about.
  • Also, with more information, there is increased risk of finding contradictory facts, which again leads to more uncertainty and worry.
- Scanning for uncertainty:

  • Worriers are on the look out for uncertainty nearly all of the time.
  • Scanning does not mean that uncertainty is reduced, in fact the opposite happens - it increases.
- Avoiding committing yourself to people/social situations:

  • Rather than choosing to commit or not to commit, worriers avoid doing either, which leaves them hanging in uncertainty.
  • Worriers often avoid commitments because they can't be sure how it will turn out.
- Procrastination:

  • This is where worriers find every excuse to avoid dealing with an uncertain problem or issue. For example; putting off a conversation with a friend because they can't be sure how it will turn out.
- Looking for reassurance:

  • It is helpful in the short term because we usually feel much better once someone has told us that everything will be ok, but it is generally short lived.
  • Worriers can seek reassurance repetitively but this triggers more uncertainty and worry.
- Overprotecting others - avoiding giving others responsibility:

  • Worriers tend to look out for others and at the same time worry about them.
  • This is just "just in case" strategy.
- Checking and re-checking - avoiding making mistakes:

  • Worriers often feel uncertain about decisions or choices they have made and consequently revisit decisions or choices to see if they have done the right thing.
  • The 'what if' question shows a seed of doubt so we check the answer to reduce worry, however this only creates more.
- Post-mortem worry:

  • Once worriers have made up their mind about a decision, they then doubt whether they have made the right decision.
  • They will ask "what if I have made the wrong decision?"
  • Their questioning stimulates uncertainty.
- Thought suppression:

  • One unhelpful way to deal with worries is to try and push upsetting thought out of your mind, or trying not to think about something that is worrying you. This is similar to the pink elephant experiment.
The pink elephant experiment:

Step 1: Close your eyes and try very hard not to think about a pink elephant for the next 60 seconds.

What happened? Chances are all you could think about what a pink elephant!

Often people find that by trying to push thoughts or images out of their mind they come back stronger.

Step 2: Close your eyes and try very hard to keep thinking about a pink elephant for the next 60 seconds. Try and hold that image of a pink elephant in your mind.

Were you able to do it or did your mind wander?

Suppressing thoughts is not a helpful or effective way of dealing with your worries. Trying to push worries out of your mind and stop thinking about them will probably make them worse.

Also in the third session, I learned about helpful behaviours to deal with worrying. I was taught how the worry tree work and how to do the worry tree for my worries. This is what the worry tree is like:


You must start at the top and work your way down.

As you can see, the worry tree is a good way of deciding what type of worry you are dealing with and what strategies would be most helpful.

Other strategies for hypothetical worry is:

- Worry time: This is where you postpone worry. You must give yourself a set time of the day when you have permission to worry. For example: 6pm each evening. You must then allow yourself to have 15-20 minutes to worry. In this time you can write down your worries and then forget about them.

- Mindfulness: Mindfulness has its roots in Buddhism and is taking a non-judgemental approach to your thoughts and worries. The idea of mindfulness is to let go of your worries without making any attempts to push them away or get involved with them. Try to become a casual observer of your worries - notice that they are there, observe them and then watch them drift away in their own time, just like you would passing clouds in the sky.

We also taught how to be mindful. This is how to be mindful:

- Be aware of your worries: Notice and acknowledge what you are worrying about.
- Observe and listen: Try to not react to the worry. Instead, observe the worry and listen with interest to what it is about.
- Let go: Visualise the worry as a transitional thought, much like a passing cloud or wave on a beach, which comes and goes.
- Focus on the here and now: Focus on your breathing, any physical sensations you are currently feeling (e.g. your feet on the floor) and your surroundings.
- Practice makes perfect: This can be difficult at first but keep practicing and it should get easier.

The last thing I learned in session three was about relaxation. Relaxation is a great way to reduce stress, anxiety and worry. Try to make relaxation a part of your daily routine. A good time to do relaxation exercises is before bed, as this will help you with sleep. There are many different relaxation exercises to do. Purchasing a relaxation disc with progressive muscle relaxation on it. It will help to relieve the muscle tension in your body from head to toe.

I know that relaxation can be difficult at first and therefore it may not work straight away. There are some relaxation exercises that focus on your breathing, some on the body and some on visualization.

I hope that you enjoy reading my experience with anxiety and I hope that what I have learnt and told you helps you with anxiety and/or depression. Thank you for staying and reading to the end of this blog. Part 2 of my experience with Talking Therapies will be uploaded tomorrow. Enjoy yourself and remember to relax.

Natasha

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