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Managing stress and anxiety

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Article written by Dr Meg Arroll

Date published 16 June 2020

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Since the COVID-19 pandemic, many things have changed. Not knowing what the future holds, grappling with altered daily patterns, and for many, increased demands at home where the lines between work and family life have blurred, can all lead to heightened anxiety.

Here, Dr Meg Arroll explores how we can cope with the symptoms of anxiety and regain control of our feelings.

Anxiety - what is it good for?

Anxiety in itself is not fundamentally 'bad'. Yes, it can feel horrible, thanks to physical symptoms such as racing heart, palpitations, sweaty palms, dizziness and tummy upsets, but it is in fact an adaptive physiological process that has allowed us to survive. The problem we have is that these sensations are driven by the fight-or-flight response, which our ancestors needed to either escape or slay predators, but which has not evolved with modern life.

This same stress response is triggered when we anticipate danger, as fears over health, financial security and our children's futures weigh heavily on our minds.

Added to this are the demands and stresses of daily life, so it is completely understandable that we are experiencing feelings of being overwhelmed and a sense of teetering on the edge. Despite the challenges, there are many things we can all do to help us cope during these uncertain and challenging times.

Coping with fears

Repetitive and ruminative thoughts are fuel for anxiety, which feeds off the worries that swirl round and round in our heads. As human beings, we very much dislike uncertainty – this is again an evolutionary and innate mechanism, as we're more likely to survive if we know what's coming. Therefore, doubts over what the future holds (both immediate and long-term) produce uncomfortable mind and body feelings which drive us to find answers.

The key in a situation such as this is not to grapple with these troubling thoughts of what might be, but rather sit in the present to calm the stress response. Mindfulness techniques are a good way to do this, as they can be practised at home and, like any skill, the more you practise mindfulness, the easier it will be to reach a state of relaxation. So, to begin, why not try this technique during times of stress and anxiety.

5-4-3-2-1 Mindful senses technique

To start, sit comfortably and anchor yourself in a deep breath through your belly - feel it rise on the inhale of three and dip on the exhale of four. Now, close your eyes and bring to your mind's eye the place where you've felt most at ease and relaxed. This can be anywhere, real or imagined, near or far - the boundaries are limitless. Next, follow these steps:

  • Focus on 5 things you can see: scan your scene and look for five things that you can see. If you're in the countryside, is there grass or gravel under your feet? What's on the horizon? Are there walkers in the distance? Look for five things: five things that you can see.
  • Bring to mind 4 sounds you can hear: what sounds or noises are in the imagined environment? Can you hear birds signing, a tractor ploughing through a field or a dog barking nearby? What pitch and tone are each noise making? Four sounds: focus your mind on four sounds you can hear.
  • Now think of 3 smells: breathe in three distinct scents. What does the freshly cut grass smell like on this summer's day? Are there wildflowers or ripe berries in your landscape? Are these aromas fragrant, sweet or piquant, for example? Three things: three things you can smell.
  • Next, bring to your conscious awareness 2 physical sensations: look inwards and discover what you can feel on your body. Can you feel the sun beating down on your brow? Or gentle wind lifting your hair? Notice how this feels. Two sensations: two sensations that you can experience in your mind.
  • Finally, step back from the detail and notice that 1 overarching feeling: how do you feel right now? Sit with this for a moment. And when you're ready, gently take a breath, open your eyes and re-enter the world.

With any luck, by the end of this exercise you will feel calm, relaxed and grounded. Please note that, often when someone begins using mindfulness techniques, their mind wanders. If this happens at any time, do not reprimand yourself, but instead gently nudge your attention back to the mindful task.

The STOP technique

When we're anxious, we not only have intrusive thoughts, but may engage in mindless behaviours such as grazing on unhealthy foods or scrolling online with little or no focus. The following techniques can help to halt both unhelpful thoughts and behaviours in their tracks.

Use the following steps:

S is for Stop. Pause for a moment and stop whatever you're doing

T is for Take a breath. Ground yourself by reconnecting your mind and body through a deep breath to anchor you in the moment.

O is for Observe. Now increase awareness of what's happening right now - how do you feel? What sensations, thoughts and actions are you engaged in?

P is for Proceed. Make a mindful decision about whether you want to continue with the present action, e.g. continue reading the news, or it would be better to turn your attention to something less anxiety-provoking.

Often just bringing awareness to your actions is enough to halt anxious feelings. You can use this technique to check in with yourself and make an informed decision about the behaviours and thoughts you want to engage in, rather than letting the anxiety thought-behaviour loop continue unabated.

Practical coping techniques

Three everyday activities to work into your routine that can help reduce anxiety.

1. Walk it off in the sunshine

Just 10 minutes of moderate exercise such as a brisk walk can lift mood, reduce feelings of anxiety and improve general wellbeing. Sun exposure is also very important to regulate our sleep-wake cycle known as the circadian rhythm. Our bodies rely on the natural day-night pattern, so when we're stuck indoors with little direct daylight, the production of the sleep hormone melatonin can be impaired. So, a morning stroll not only helps physical fitness, but also promotes good-quality sleep.

Getting out and about also allows our bodies to produce vitamin D, low levels of which can lead to low mood and a less robust immune system. Foods such as oily fish and mushrooms are high in vitamin D, or you may want to use a supplement.

2. Be 'hygienic' when it comes to sleep

Although the focus at the moment is on good hand hygiene, to manage anxiety good 'sleep hygiene' is vital, too. In general, this means going to bed and getting up at regular times, keeping the bedroom cool, dark and well ventilated, removing sources of blue light which inhibit sleep such as TVs, tablets and smartphones, and overall making this room an oasis for rest.

Winding down properly in the evenings is also vital for sleep, as this routine will tell your mind that it's time for bed. This could take the form of breathing exercises, reading, or listening to an audio book or relaxing music. We know that it's better for our body temperature to cool down instead of having to warm up for sleep, so consider taking a bath as part of your evening routine.

3. Talk it out

Turn to friends and family and share your feelings, experiences and fears. But if you find it hard to confide in those close to you and are struggling to overcome anxiety, there are professionals who can help. The NHS set up the Improving Access to Psychological Therapies (IAPT) programme in 2008 to provide professional mental health services, which can be accessed via your GP or in some areas through self-referral. Search using this page for services in your local area, as no one should suffer in silence.

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About Dr Meg Arroll

Dr Meg Arroll PhD CPsychol AFBPsS is a chartered psychologist, scientist and academic researcher with a specialist focus on health and stress, integrative medicine and wellbeing.

drmegarroll.com