Managing anxiety and worry

There are many strategies and techniques that can be used to help cope with worry and anxiety. Some involve strategies to help reduce physical symptoms of anxiety directly through methods like muscle relaxation, imagery, or breathing exercises. Other strategies are designed to teach worriers to change catastrophic thinking so that imagining worst case scenarios and predictions of disaster are either reduced or such thoughts aren’t taken seriously. Treatment strategies used by professional health care providers usually address both problems.

Professional help

Professionals such as physicians, psychologists, counselors, social workers, and psychiatrists are trained to help mange anxiety. If you seek professional help for managing anxiety, it is important to find out whether the professional you are talking to has specialized training in treatinganxiety disorders. If not, try to find someone who specializes in treating anxiety. One online resource for identifying specialists in this area is the Anxiety Disorders Association of America (www.adaa.org).

Psychotherapy

Therapists use a variety of techniques to help with anxiety. Techniques and strategies that work for one person might not work for another. So, it is important to be able to communicate with a therapist about what is or is not working. Some of the most common therapies for treating anxiety are Cognitive-Behavioral Therapy (CBT) and Exposure Therapy.

CBT is a treatment that focuses on how thoughts and feelings influence behavior. CBT teaches individuals to recognize when their thoughts are unrealistic and contribute to anxiety. The therapist works to help change maladaptive thoughts and beliefs to more realistic thoughts and to determine what behaviors are the result of the unrealistic thoughts. Realistic thinking results in reduced anxiety. Exposure Therapy is a treatment strategy in which a therapist works with a client to seek out, under controlled conditions, anxiety producing situations that the client finds frightening. By doing so, individuals learn that the feared situation is not dangerous and that the catastrophic thoughts are not accurate. With practice, the catastrophic thoughts about the situation are no longer able to create fear.

Medication

Physicians and psychiatrists can prescribe medications that change how the chemicals in the brain are produced and/or work with other chemicals. Medications are not universal, meaning any specific medication may or may not be effective based on your body type or sensitivity, and may some have side effects. Research indicates that medications for anxiety, especially for panic disorder, are more beneficial when they are combined with cognitive therapy. The doctor who prescribes the medications will monitor mood and health closely to determine if the medications are beneficial.

Reducing Physical Symptoms of Anxiety

Relaxation exercises to reduce physical tension are powerful tools for calming both the mind and the body. However, it is important to understand that these exercises shouldn’t be used to “escape” or avoid anxious thoughts or behaviors. These strategies are best used to calm and relax more effectively after you have addressed your fear, anxious thoughts and/ or behaviors. To learn more about these skills, visit the Life Stress booklet on AfterDeployment.

• Progressive Muscle Relaxation - Progressive Muscle Relaxation teaches relaxation of the muscles through deliberate tensing and relaxation for each of the major muscle groups in the body. After practicing progressive muscle relaxation over time, it becomes easier to identify a tensed muscle and relax the muscle with the tension and relaxation sequence, reducing overall tension in the body and contributing to a sense of calm.

• Guided Imagery/Visualization - Guided imagery and visualization promote relaxation by painting a mental picture of a calm, safe place. After practicing this technique several times, individuals are often able to use visualization on their own. This technique helps to reduce worry by reducing overall stress.

• Diaphramatic Breathing – Often called “belly breathing,” diaphramatic breathing is simply taking deep breaths of air into the lungs using your diaphragm and exhaling slowing. Repeated diaphragmatic breathing helps to calm the nervous system and the “fight-or flight” response.

• Distraction - In addition to these formal techniques, try engaging in an activity that is relaxing for you. Relaxing activities vary from person to person. Relaxing activities might include reading, playing sports, spending time outside, listening to music, practicing yoga, playing with a pet, etc.

Changing Worried Thinking

Risk Assessment:

People who worry frequently tend to overestimate the risk of specific situations; they view a situation as being more risky than it actually is. Most worriers focus their time and attention on the worst case scenarios and then engage in catastrophic thinking, which only makes the problems and worries seem worse.

Individuals who spend most of their time and energy worrying tend to forget that they have the ability to cope with many stressful events. Learning to accurately assess risk can greatly reduce anxiety.

Resources

Websites

• Anxiety Disorder Association of America ( http://www.adaa.org /)
• National Institute of Mental Health ( http://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml )

Books

• Mastery of Your Anxiety and Panic: Workbook by David H. Barlow and Michelle G. Craske
• Get Out of Your Mind and into Your Life by Steven C. Hayes, Ph.D.
• Finding Life Beyond Trauma by Jacqueline Pisterello
• The Anxiety and Phobia Workbook by Edmund J. Bourne