Disclaimer
I'm not a neither a psychologist nor a psychiatrist, I have no medical background and I can have totally misunderstood some of the things I went through, bear with me and do not hesitate to reach out to me if you found something that doesn't make sense.
Introduction
I've spent about a month now reading, watching and reseaching about anxiety to try to find ways to help my wife sort her anxiety issues. The idea is to find progressive ways, that will help her get better and that will last and help avoiding relapsing.
I simply want to share what I found out up to now for the people it could be useful for.
References
So here are some of the things I went through with some insight of what I found out through each, and what I feel is important to keep in mind from these.
That is indeed a bit long, if you want, you can simply go through the videos and not bothering reading my summary/analysis, but the ones I'll share here are worth watching in my opinion.
It all started with the first video you'll find below, a TED Talk having interesting pieces of information about how the brain works and how our feelings can affect what we think.
What reality are you creating for yourself? | Isaac Lidsk
I highly recommand watching it over reading my summary below, it may seems unrelated at first, but believe me there are pieces of information that are worth the watch.
What you see impact how you feel / the way you feel can literally change what you see
What you see is a complex mental construction of your own making, but we experience it passively as a direct representation of the world around you
Sight is just one way we shape our reality, we create our own realities in many other way
That's when he starts talking about fear and it gets interesting for anxiety, the most interesting point to keep in mind to try to make sense of how anxiety leads you in its trap is that:
Your fears distord your reality, under the warped logic of fear, anything is better that the uncertain. Fear fills the void at all costs, passing of what you dread for what you know, offering up the worst in place of the ambiguous, substituting assumption for reason. Psychologists have a great term for it: awfulizing. Fear replaces the unknown with the awful.
With some edit to ease the transcription here:
Fear shrinks and distords you view, drown your capacity for critical thought with a flood of disruptive emotions
Fear lulls you into inaction, enticing you to passively watch its prophecies fulfill themselves.
In my opinion he doesn't provide solution for anxiety, note that it wasn't his point in the first place, still, his advices are good, but too generic and not easy to simply follow for an anxious person:
Hold yourself accountable for every moment, every thought, every details. See beyond your fears, recognize your assumptions, harness your internal strenght, silence your internal critic, correct your misconceptions about luck and success.
He then emphasize on this, which basically is what cognitive theray is meant for: identifying the flaws and distorted perception, realize the mistakes and learn to spot them before getting deep into it.
How to hack your biology and be in the zone every single day
As you may have guessed from te title this isn't directly related to anxiety in the first place either, but there are a lot of explanation about how you brain can be impacted by your stress and the chemicals that comes into play.
He is using cardiac coherency to show when you're at peace or not, and explains the simplest way to regulate it: rythmic and smooth breathing.
He also exlains with simple 2 axis diagram the stress/relax and good/bad states, and that no matter if you're pumped/stressed, if you are on the good side (so when you heart rate variation is coherent), you'll be able to make the best out of this state.
I highly encourage watching the whole video, but to make some quick notes to remember:
- cortisol, also known as the stress hormone, get you chaotic variance
- DHEA give a more stable and coherent hear rate
- rythmic breathing helps getting a coherent heart rate and reducing cortisol
Ain't much, but that's pretty important!
Your body language shapes who you are - Amy Cuddy
- Body language can impact the way we think and the way we judge ourselves
- Power poses for 2 minutes do have a tested impact on biological
- reduced cortisol: less stress
- higher testosterone: more risk tolerant, more confidence
Rethinking anxiety - Learning to face fear _ Dawn Huebner
This mostly talks about Cognitive behavioral therapy and ways to use it. She explains why it is important to face fears to finally understand that the fear response we had for this thing was a false alarm. For this it is useful to find ways to get your attention on something else, like meditation, rythmed breating, mindfulness...
How to make stress your friend - Kelly McGonigal
I'll simply sum up what I think is the most important, especially for illness anxiety (i.e: awfulizing on healh: my throat hurt, it must be a throat cancer)
- Stress when not getting worried about being stress is a helpful respond and is, proven by medical study, harmless to your health.
- Stress is a fear reaction that will switch your body in a state to be more efficient, so if not worried about it, it can help you perform better
- Stress makes you release oxytocin, that will encourage you to reach out for help, and also to help others, reaching out, exchanging, helping will actually effectively help you out.
Feeling good - David Burns
This video is on Cognitive Therapy. Basically:
- anxiety send negative signals to ourselves
- anxious thoughts are false, warped by our mind, and always to the worst
- cognitive therapy is meant to identify and change the way we think, to change the way we feel
- think about what we think when we get anxious, and analyze them to spot the false and deformed things we think
- feelings are the output of our thinking
- it is not the outside world and events that are causing our emotions, but only how we perceive them and what we will think at that point
Introduction to unique and powerful features of schema therapy
- Schema therapy goal isn't to change the behavior, but to identify some unmet needs for the person and help them reaching these needs, so the associated schema will disappear by themselves.
- Identify barriers and vulnerability then the associated need
- Schema therapy won't (like most other therapy) say these needs are bad, not putting an additionnal strain on the patient, but help him/her reach it and grow from it.
- with use of limited reparenting, therapist is supposed to support and validate patient behavior to help him go over the limitations and vulnerabilities he created for himself
The game that can give you 10 extra years of life - Jane McGonigal
The most import thing to get out of it is that she suggest playing SuperBetter for small exercises that will help boost your resiliance to various things.
A new plan for anxious feelings: escape the custard! - Neil Hughes
A very good explanation with images to represent anxiety and how it feels, by someone who really lived through it. Explanations are well done, and the way he illustrate the anxiety traps as custard traps, help understanding things.
- Brain can get anything a habit and feel normal
- Habits will fuel the anxiety, unintentionally, that's just an habit
- Self-observation to detect disruptive thoughts when they happen and allow to choose your reaction is important
- Anxiety is self-reinforcing, it tires you, you feel bad, and it gets worse
- When an anxious thought pops up, you need to do something else
- Brain have path of thought, the more you use the bad ones, the stronger they will be, and the more often they'll happen -> you need new habits to overcome these path and create new ones
How to become more confident -- lay down on the street for 30sec - Till H. Groß
That is a funny one, it is a more accessible and funnier way to work on confidence, it is just a funny way to apprehend Cognitive behavioral therapy
A good watch, better seen than explained.
You are your greatest ally - Jessica Amos
A pretty short video, where she presents a small exercise that can be pretty useful if it works on you, can also be used to calm down, to divert attention on something else in case anxiety is starting to rise but is enough under control to do something like that.
Anxiety: Hibernate, Adapt, or Migrate
Not sure this will bring much help, beside seeing someone with real anxiety issues who actually got out of it and can live now.
Most important things, I'll take from there: - The fear response our body have isn't adapted to our lifestyle anymore - If you avoid things that get you anxious, you're afraid of, the threat level they are to you will raise, that's why Cognitive behavioral therapy is interesting
She also quotes a book
mastery, autonomy and purpose are the 3 nutrients that feed our intrinsic motivation and they promote our greater physical and mental well being
Small summary
So to sum it up here is a small overview of what I think is important.
Cortisol
This is known as the stress hormone, and it will prevent you from logical reflexion and analysis, one of the goal I think, is to find ways to reduce it.
- Magnesium can help, there are pretty cheap food supplement, make sure if you go this route to take one with vitamin B6 too, as it helps the assimilation of magnesium
- Power poses for 2 minutes helps reducing it, I guess this is short lived, so better do it trying something you're not at ease, or when you know you'll be start thinking a lot and entering an anxious loop
- Cardiac Coherency can help regulate it and make yourself more able to analyze and therefore use logic to refrain anxious thoughts, more on it on its own section below.
- If possible, reduce caffeine and tobacco, but these are addictive, and can create new stress when trying to reduce or stop, if you don't feel like it, don't to it, it won't make you any good if you're more stressed
- Relaxation and Meditation and Mindfulness can be of help, but may as well create an issue, when trying to get distance on your thoughts they may as well let you more time to think and enter an anxious loops. My guess is that it will depend from your condition, but I'm not sure that is a good idea for most people with chronic anxiety.
DHEA
It kinda is at the opposite spectrum from cortisol, your body generates it, some food may help your body producing it, but I haven't found anything that seems really serious about it for now.
There also are food supplements, but apparently they are still not allowed everywhere, can make athletes positive to drug test, and effet on longer term are not well know.
I haven't done much research on this yet.
Cardiac Coherency
Should help get to a safer level of stress and allow more logical thinking, therefore allow you to be able to detect the anxious thought and analyze them as wrong and deformed or not worth the anxiety spike and handle it a bit better.
I'm not saying this will cure everything, but that's an additional help, I'm currently searching for various small things to help the whole process.
Training 3 times a day, 5 minutes over a period of about 30 days should normally get your body to have learned it and be more at ease to do it on its own, and to use it in case of a spike of anxiety before you're too far down the spiral of fear.
There are apps, I only have android phones so I only list those I tested on my phone:
- Kardia Cohérence & Relaxation:
- free
- simple
- no heart rate monitoring, it is a simple trainer
- it works fine, I like it
- HeartRate+ Cohérence PRO
- not free
- actually measures the heart rate either via camera + flash, or bluetooth heart rate monitor, via camera isn't very accurate sometimes
- do not work will all bluetooth monitors, mine sends an average rate, and cannot be used for that
- actually gives you graphs
- too bad I didn't get a monitor that works fine and camera isn't very accurate for me, it probably could have been a good option
- free for 1:30 min, so you can test out if it works for you in one way or another
- Feel
- app is free, but it requires a sensor that they sell on their website
- complete with graph, history, various level of guidance depending of your level
- that's what I ask my wife to use right now
I would suggest to do it before sleeping to try to take advantage of the Memory Consolidation during sleep.
Sport
That may sound pretty stupid, but if you can find a sport that will make you workout enough to release endorphin, it helps feeling better, and thinking clearer generally.
Again, this won't be a miracle cure that solves everything, it is an additional stuff that can help you out a little.
- Keep you busy for a while, as long as it makes you concentrate on the effort you're doing (I fear things like jogging or rope jumping may actually leave too much brain time to think... everyone is different, try it out!)
- Releases endorphin, feel better
- Better confidence in your body
- More fatigue, chances are you'll fell asleep more easily and sleep better, because of the physical fatigue instead of the nervous one
Cognitive Therapy
Cognitive Therapy is meant to analyse the false assumption, the wrong idea you tell yourself, detect them, analyze them and prove them wrong.
In my wife situation that would be a good plan, if she could actually beleive the analysis we do together. Let's take an example:
- She has a sore throat, she starts thinking she has a throat cancer.
- People without anxiety issue will simply tell her: go to the doc, he'll tell you that's nothing.
- People with anxiety issue will know that going to the doc is the scariest thing ever, becaus in an anxious mind, he will confirm that this is a throat cancer and that you're on the verge of death.
The fact is, if we take this idea and try to analyze it together, I can't prove that it isn't a throat cancer, and she'll therefore know there is a possibility it can be that, and won't accept the fact that this possibility, this thought is absolutely wrong and that there is nothing to fear.
So the principle is good, but the application isn't easy, also, apparently the relapsing rate is pretty high, especially for anxiety.
Cognitive Behavioral Therapy
Cognitive Behavioral Therapy, as explained a bit earlier is mainly aimed at facing the fears, because avoidance will let them grow and become more and more of a danger in you mind. So facing it more and more enable the idea of a thing to be frightful to become less scary over time and repetition.
In my wife situation, the fear of sickness cannot be treated by this, but her fear of social interaction, of going out on her own, or to take a car drive (as a passenger, she doesn't drive) can be impacted by this.
As the Cognitive Therapy, the risk of relapsing is pretty high, in my experience, if any situation that became bearable to her, triggers a panic attack again because she wasn't that well this day for example, will go back to its previous state, or even worse, as she'll avoid it more and more and therefore strengethen it.
Schema Therapy
Schema Therapy is apparently using part of various other fields in therapy, amongst them are CT and CBT of course, but it has a different apporach that tries to be more positive and more self healing. I haven't finished my work on this, I bought books that I am still reading right now so it may be a bit early to talk about it too much.
Interesting part is that the schemas are the way we react to events, there are adaptive and maladaptive schemas, and early or late schemas, this theory focuses on the one called: early maladaptive schemas which are schemas learned earlier in life, and that are not using the right way to deal with the situation.
I won't enter into the details of the various parts to work on for a schema therapy, but what is interesting is that by finding the needs and they source in an early maladaptive schema, this therapy aims to help the patient to fullfil its needs, and therefore heal himself from the root cause of the issue, helping rewiring this schemas to a more functional one for each situation.
Jeffrey E. Young, the one at the source of this therapy, wrote various books, I currently own two:
- Reinventing your life: which is targetted at people who want to work on themselves on their own
- Schema Therapy: A Practitioner's Guide: which is more targetted at therapist, with more explanation of the principles and the steps and parts of the therapy. I'm currently reading it, and it has a lot of useful informatino, even at the beginning simply to understand how schemas works, where they come from and how our brain uses them.
One drawback is that from what I'm currently reading it looks like you'll most lilkely need a therapist that knows this very well to go through a full healing. I'll may change my mind once I read reinventing your life, but I wanted to know as much as possible on the principles before starting it, that's why I went directly with the bigger, longer and more detailled book first.
Conclusion
So in order to get various small stuff going, I would suggest making a plan, a progressive plan for you to incorporate the small stuff, especially if you're not yet heavily handicapped by your anxiety: DO NOT LET IT GET YOU ANY FURTHER.
Again I'm no doctor, therapist or anything related, these are just suggestion to help out if that can bring any help to anybody, this doesn't have to be done in that order, you can take the progression as slow as you want. And in the worst cases, theres is nothing better than having a good therapist that cares about helping you out and with whom you feel ok.
So my suggestions: - Magnesium + vitamin B6 cure - Play superbetter everyday - Sport - Cardiac Coherency training, with one before bed for memory consolidation - Cardiac Coherency when anxiety rises - Power poses for 2 minutes before stressful thing on when anxiety start - Power poses for 2 minutes before bed, I would say before cardiac coherency - Reach out to others, talk about it, be open about it, and do NOT take personally or badly things they say, that shows they don't understand, better try to explain better to them, and if they act like it is your fault, or still don't get it, find nicer people, or people with more empathy to talk about it. - Taking notes of disruptive thoughts, analyzing them on the spot if possible, later if you can't do it at the time they are coming. - Facing some of the fears, confort zone challenges, whatever way feels the best to you, but that has to be done regularly, not once every now and then or the benefit of the "there finally was no danger doing that" will disappear and won't make any benefit to you - Reading Reinventing your life to find other ways to help yourself
Hope this can be of any help to someone, again, not a doc, I'm just a software engineer trying to find ways to help my wife, and thought the month worth of reaserch I did was worth sharing...