I nearly had a panic attack at the last parent- teacher evening but I made an excuse and left in time.

This can be true of any type of daily activity such as grocery shopping, doing dishes, watching television, etc. NEVER belittle or try to downplay someone's Anxiety Disorder. Regular relaxation puts you more in tune with your body, which helps you to recognise the physical sensations that are signs of deeper emotions. Its something about the steady rhythm that soothes me. My feeling is, if this is what Ive had, now I know how to deal with it - its simply a reaction to some stress, its not a physical illness. Focus on the word relax, and breathe gently and calmly. If youve been practising the breathing exercise in Part One you should now feel confident enough to use it to reduce Anxiety levels. Lets look at the example of someone with social phobia. This simply isnt true. Why not try to help yourself in the meantime? Heres an example for someone with spider phobia: Situation: leafing through magazine, saw photo of large spider. Its not this living nightmare that turns every minute of every day into a torment of worrying. Blood/injection/injury type, like the fear of medical procedures including needles, hospitals. I thought I must be losing my sanity, what other explanation was there? I had to kneel at one of the graves and rub my hands in the dirt amongst the gravestone, . I took a lot of time off. Im the best parent I can be. How shall I talk to the doctor? If they are afraid of other people, they need to practise being with other people. Look at possible solutions. If you are in a situation where you dont need to take any physical action, such as in a queue or driving a car, then that oxygen will stay in your system and add to your uncomfortable sensations.

Ask them to limit the number of times they give reassurance to you.

Relax. Once you have a record of your sleep over a period of time you can examine it to see if there is a pattern. Symptoms include: severe debilitating fatigue painful muscles and joints problems sleeping digestive problems poor memory poor concentration. Emotional: fear, and ashamed of need to keep cleaning toilet. Self-fulfilling prophesies will lead you to give up trying to recover, because you think the world doesnt hold anything worthwhile for you. Whatever your particular experience, you can be as sure as eggs are eggs, there will be difficulties at some point, so you might as well have an understanding of how to deal with them. Over-generalising usually includes words like never, always and every, so typical examples are: Ill never manage this goal. Im always the one who struggles. Filtering Filtering means selecting one aspect of an experience and focusing on that - and of course for an Anxiety sufferer this is going to mean filtering out the positive and focusing on the negative. You may have a panic attack if you venture out to the shops, you may feel worse rather than better if you cut down your rituals, you may embarrass yourself in public if you go out into the world. You may decide to explore your creativity, learn a new skill or widen your social network. These attacks can occur at any time, and even while the sufferer is asleep. This isnt pleasant, it isnt fun. Breathe in and out through your nose and let your breathing slow down. Hold it and feel the tension in your forehead. The worrier Worrying is part of the human ability to look into the future and make decisions based on the likelihood of something haping - worrying that it looks like rain will cause you to take an umbrella for instance. Youve started to work towards recovery and however tough things get, you can find a way to keep going. I cant work so my income is low. Cognitive work and OCD Ask yourself the question: Do my rituals really make a difference or are they driven by my Anxiety? It often means looking for a compromise solution, where you can have what you need without depriving someone else - known as a win-win solution. This can be healed but self-help may not be sufficient, especially for working on experiences which occurred very early in your life, before you had developed language or thought capacity to understand what was haping. They feel as if they are constantly being judged or watched by others for no apparent reason other than those things they themselves feel self-conscious about.

Touch the photo of a spider.

BDDis not classified as an anxiety disorder. Examine your records from the exercise above and be honest with yourself about the amount of alcohol you consume - could you, for instance, go a whole week without an alcoholic drink? Do this for several breaths, rhythmically. Some forms of Anxiety, such as compulsive behaviours, are very time consuming, and other types of Anxiety can leave the sufferer feeling too exhausted to contemplate taking exercise. Has this been true in the past? Other type (such as situations that might lead to illness, choking, vomiting). Say I wont be able to give anyone a lift on Tuesday evenings, thats going to be my evening off. Excitement - you have a whole new life. What is your body to do? Eventually someone with agoraphobia needs to practise staying in situations, so they could move on to the shopping ladder in the panic example, or they could devise a new ladder that focuses on being with other people. At one time they were prescribed without a full understanding of the side effects of long-term usage. Ask someone else to take over the fixture list. I dont find it difficult to be assertive. I do find it difficult to be assertive, but Ive improved over the years. Counsellors have a saying if you do what youve always done, then youll get what youve always got. In other words, if you keep telling yourself negative things, then youll keep failing in the very ways that you dont want to fail. If you are worried about your Anxiety returning, thats understandable, but you now have new insight and new skills. When the panic attack subsides, the person naturally feels that leaving the situation is the answer - when you leave, the panic stops. I just felt relieved. Perhaps you are realising that things arent as bad as you thought, or perhaps youve had to face up to the full extent of your illness. If you think that panic will cause the skills to fly out of your head, write your chosen ones on a little card to carry with you. Try to build up a more balanced picture by recording your own achievements and asking those around you for honest feedback.

If there is a new beginning, then there must have been an ending.

If youve had Anxiety for a long time, and think that you know everything it can throw at you, then it can be very frightening if these feelings of unreality suddenly develop on top of everything else you have to cope with. It seems to be the case with all human beings that once we have managed those basic human needs (food, water, air, sleep) we then turn our attention to other matters. And if it doesn't, get them to the nearest emergency room as soon as you can. Even though you can tell someone that is having an Anxiety attack that "It's All In Your Mind", this usually comes out leaving them feel you are trying to be condescending to their plight. If someone is ill and needs our help, if there is a rush on at work, after a death or during any other stressful event, our instincts take over and get us through it. There are support groups, counseling services you should take advantage of, Anxiety related programs to help you make sense of and learn to control your Anxiety, and of course there are effective medicines your doctor can prescribe for you if necessary. They will. Id go mad, or something. YES/NO If you take it steadily you will manage it. My feeling is, if this is what Ive had, now I know how to deal with it - its simply a reaction to some stress, its not a physical illness. It can be something as simple as a relaxing bath, watching your favourite TV programme or reading a magazine. Does it feel to you as if making changes is just too risky? Four years before I had a severe ear infection that led to balance problems, which was very frightening and went on for 10 months. Nicotine Per day Alcohol Per day Per week Prescription drugsPer day Check with GP about side effects Street drugs Per day Per week ABOUT ALCOHOL, NICOTINE AND OTHER DRUGS I used to smoke, up to 50 a day. Here is a list of symptoms (you are unlikely to experience all of them): depressed mood most of the day, nearly every day tiredness. If you are nervous about doing this, consider taking someone sympathetic along with you for support. They may also come up with explanations that are way off beam - such as thinking youre unfriendly, or consider yourself too good to mix with them. And a great sense of achievement once I had completed them. Achieving Life Balance and Managing Your Time Anxiety disorders often develop after a period of stress in your life, and if your score in Chapter 7 was higher than 150 then this is likely to be the case for you. The next stage was for me to listen to the tape on my own, knowing that I could phone him.

Theory B prediction: I will be anxious as I imagine all the danger.

Examining your negative core beliefs You have already started on the first step, which is identifying your negative core beliefs. So examples of core beliefs might be: Im fine as I am other people generally mean well the worlds my oyster. I have tried to change my mindset. Dont dismiss this, or feel ashamed of it - but do use countering statements to help the frightened child in you let go of its extreme thinking. Like all Anxiety sufferers, your first steps in exposure work will be mainly a test, to see if it is really true that these awful feelings are caused by Anxiety and that Anxiety can go down. Youve learnt a little more about healthy breathing. The first time you step into the place youve been avoiding, the first time you walk away without finishing your ritual, will be challenging. Answering both questions might produce two quite long lists, for instance: They may not know why you keep turning down invitations, or refuse to go on holiday with them, but they do know that something is preventing you. Feel the tension in your fists. These smaller personalities are called sub-personalities and they are all equally important to making up the unique being that is you, and in a healthy person they all have their uses and balance each other out. Youll be able to recognise the early warning signs of Anxiety, and youll know which techniques work best for you so that you deal with it before it takes hold. Although the thoughts and rituals may seem quite strange, psychologists believe that they developed for good reasons - usually as ways for a child to get through a difficult situation. These things are not easy, and for some people retreat into Anxiety can seem like their best option. The ancient Greeks knew all about this and they called it catharsis. Relax your arms and let them fall back comfortably. Some phobias might belong in one category or another, deding on what the actual trigger is, or be part of a more complex condition such as agoraphobia. Anxiety makes you tense, and tension make you breathe in a shallow, fast way, using only the top half of your chest. Or as close as it can be described. Delight - think of the joy youll feel when you manage your goal, or focus on the pleasure your success will bring to the people who care about you.

Arrange a time when you wont be disturbed - if there are other people around, explain that you need to be alone for a while.

The cognitive work youve done so far will help you identify the emotions that are driving your thoughts. If someone feels trapped in an unsatisfactory life, or feels that they were cheated in the past (of education, career opportunities or the ability to be themselves for example) then their anger is likely to break out in the form of Anxiety. In all of the following exercises that work with your thoughts, you will need to keep repeating them until you find your thoughts changing. Do this if you wish - maybe in the back of the notebook. There are various things the doctor can suggest to help you: Lets wait and see: if your Anxiety is very new, it can be a sensible idea to wait a couple of weeks to see if it subsides. Where To Get Help For Your Anxiety? Shrug your shoulders, bringing them up towards your ears. Do choose someone who is registered with the United Kingdom Register of Counsellors (UKRC). Anyone with OCD whose obsessions and compulsions are both thought-based still needs to do exposure work, although they will need to design their programme around their compulsive thoughts rather than behaviours. Imagine your lungs have three sections - top, middle and bottom. You can set goals that aim to cut down the number of thoughts, or reduce how many times you allow yourself to go round the thinking loop. It mustnt feed into your Anxiety (such as saying a prayer if you have compulsive thoughts around prayer). ABOUT BREATHING I dont work on my breathing, I find that really difficult. We are programmed to sleep when it is dark and to be active when it is daylight, so we may sleep more in winter. It is frightening but not dangerous. It is much more realistic to expect setbacks and plan for them, rather than assume that your recovery is going to go without a hitch or two along the way. The worrier Worrying is part of the human ability to look into the future and make decisions based on the likelihood of something haping - worrying that it looks like rain will cause you to take an umbrella for instance. These things are not easy, and for some people retreat into Anxiety can seem like their best option. After the session - all anxiety disorders When youve finished the session, write it up in your notebook in the usual way. Facing up to difficult issues Once you have worked out what it is that you find difficult to face, you can decide if theres anything that can be done about it.

Someone with Anxiety is likely to be stuck with one or more of the following types of negative selective attention.

Of course its true that many people alive today do not have the luxury of worrying about their self-esteem, or their core beliefs, because they are entirely focused on survival - enough to eat, a future for their children. If you can deal with your feelings as they arise, youll be more able to live in the present, and less bogged down in the past. You need to pump more oxygen to your arms and legs if you are going to fight, or run. All their tests are negative, but somehow they cant believe it. You can choose to hold your breath, or to pant like a dog. It can seem impossibly hard to take exercise if your Anxiety has made you housebound, but in fact there are plenty of options. The middle layer consists of underlying assumptions which can be seen as a set of rules for living. The social settings can be those that occur on a daily basis, or those that are rare occurrences, such as a party, public speaking events, etc. There are more details in Extra Information Yes/No How do you feel about living with an Anxiety disorder? Along with other simple emotions such as excitement, curiosity or boredom they are usually spontaneous and short-lived. However, if your problems go deeper into your relationship with them youll have to proceed more carefully - we suggest you take professional advice (see Relate in Apdix 2). Breakdown of first goal Since this person is very unfit, there is no way they are going to run even a mile the first time they go training, so they have to work out a series of mini-goals. It can seem so unfair to find yourself having to deal with this when youve already had so much on your plate, and specially when you were looking forward to a bit of peace and quiet. Phobias Usually with a phobia the feared object is not in itself dangerous. Scientists tell us that the experience of love releases chemicals called endorphins that make us feel good and block pain. I choose to stay at home I choose to cook for the family I choose not to go in the garden I choose not to control my dog Suddenly you can see that you to have more choice than you thought. There are more details in Extra Information Write it in your diary, stick it to your bathroom mirror, remind yourself of it at every opportunity. Do you want to rush in and do everything we suggest in the first week?