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Defeating Anxiety Handbook

Defeating Anxiety Handbook

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Published by: EladeB on Jun 19, 2012
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Review previous week
How did relaxation & breathing go
Sleep - Lethargy
o Sleep cycles
o Brain Rhythm
o Basic necessities of life
Main model (CBT)
Activity Plan
Make up your own activity plan
Motivation
Homework; read handout
o Continue with relaxation
o Practice sleep
o Play CD everyday

34

35

Getting to Sleep and Staying There

You have been given a really good CD, USE IT! IT WORKS! It has a build
up effect, so use it regularly
Try and have a routine (if possible)
Go to bed when you are sleepy
Do not nap during the day
Try and get up the same time each day (even on weekends)
Try to keep bed for sleeping and romance! If possible avoid watching TV and

studying in bed. We want your mind to associate bed with a cue to “go to
sleep now”
AVOID CAFFEINE: That‟s coffee, coke, etc…It does keep you awake, so

work out what time you have to stop having caffeine if you are to sleep that
night

Alcohol and drugs make you sleep in the short term, BUT it isn‟t the right
sort of sleep and it MAY make your ongoing sleep problem worse
THE SAME with sleeping pills, they can be a great short-term fix, or a means
to catch up on some sleep, but in the LONG-TERM you need some SLEEP
SKILLS

Laying in bed WORRYING stimulates your mind and keeps you awake SO if
you can‟t put it out of your mind – write it down for attention tomorrow.
Then put something else in your mind – like music, or your sleep CD
Use your problem solving techniques before bed time so that you can tell

yourself you have a plan to deal with those worries…
Obviously if you haven‟t expended any energy during the day you won‟t be

tired…

EXERCISE during the day will help you sleep (it may not happen over night
but it WILL happen)
Eat regularly and avoid large meals before bed time. Indigestion OR empty

tummy noises will keep you awake…

Make sure your bed room is dark, quiet, and have the TV off
A hot drink (especially MILK) before bed DOES help
Or a hot bath before bed
Don‟t put yourself in a position where you are looking at the clock all night,

if need be get rid of it or cover it up

36

A GUIDE TO SLEEP

Poor sleeping habits have a profound impact on your ability to function, and the symptoms vary;

Physical Symptoms

- Pounding heart
- Cold hands/feet
- Sweating
- Nausea
- Diarrhoea
- Constipation
- Back pain
- Digestive difficulties
- Headaches
- Irregular breathing
- Fatigue
- Tension
- Voice/hand tremors
- Dry mouth
- Dizziness
- Impaired immune system
- Shortness of breath
- High blood pressure
- Vague aches/pains
- Difficulty breathing through nostrils

Psychological Symptoms

- Depression
- Boredom
- Nightmares
- Confusion
- Helplessness
- Tearfulness
- Dissociation
- Lethargy
- Urge to escape
- Fretfulness
- Anxiety

37

- Paranoia
- Nervousness
- Impaired focus
- Negativity

Behavioural Symptoms

- Fidgeting
- Smoking
- Substance abuse
- Reliance on medication
- Impulsiveness
- Reclusion
- Defensiveness
- Disorganisation
- Eating disorders
- Decreased sex drive
- Aggression
- Clumsiness
- Inflexibility
- Cynicism
- Impaired efficiency
- Decline in performance
- Nagging
- Poor self-care
- Withdrawal from supportive relationships

The purpose of breathing

The purpose of breathing is to bring vitality and oxygen into our blood stream. But there are also many
other crucial aspects in breathing; such as assisting the heart‟s pumping action, the flow of endocrine
hormonal emission from the organs as well as the movement of the cerebral spinal fluid in the spinal
cord.
- Sat Chuen Hon, The Tao of Breath

Human sleep patterns

Our sleep patterns are intimately related to the natural world. The planet turns on its axis once every
twenty-four hours, giving us cycles of light and darkness, and living organisms seem to cycle with it, as
seen in diurnal changes known as circadian rhythms.

These rhythms show up in daily fluctuations in the release of neurotransmitters in the brain and nervous
system and in the biochemistry of all our cells. We have these basic planetary rhythms built into our
systems. In fact, biologists speak of a „biological clock‟ controlled by the hypothalamus, which regulates
our sleep/wake cycle and which can be disrupted by jet travel, working the night shift, by stress, and
lifestyle patterns.

38

„We cycle with the planet, and our sleep pattern reflects this connection.

When it is disrupted, it takes us some time to readjust, to get back to our

normal pattern.‟

- Jon Kabat-Zinn, Full Catastrophe Living

____________________________________________________________________________________

Circadian rhythm

The circadian rhythm is the twenty-four hour cycle and regulates the body‟s rhythms from digestion and
elimination to the growth and renewal of cells, inhalation, exhalation, and the rise and fall of body
temperature.

All these processes are triggered through a network of chemical messengers (hormones) and nerves via
signals from the hypothalamus. The circadian rhythm ensures that body functions and sleep patterns run
to a cycle of approximately twenty-four hours, irrespective of our environment.

Melatonin

Melatonin is produced by a pea-sized gland at the base of the brain called the pineal gland. It is the
hormone that causes sleepiness and sound sleep. Darkness is one of the main triggers for melatonin
production to increase, causing the body to start slowing down in preparation for sleep.

Light entering the eye through the retina causes melatonin production to reduce, causing the body to

awaken. The pineal gland‟s capacity to keep up the production of melatonin declines with age.

Ultradian rhythm

A one-and-a-half-hour cycle, the ultradian rhythm produces altered states of awareness naturally and
rhythmically throughout the day and night. Each cycle lasts twenty minutes and seems to be the natural
healing state of the mind and body.

These cycles provide a natural „time out‟ when conscious awareness is toned down. We need to learn to
recognise this rhythm in ourselves and flow with it without resistance.

The stages of sleep

Stage One

- An electroencephalogram (EEG) displays wavy lines during this stage – fairly regular, small
undulations;
- Drowsiness dominates; a light phase, lasting approximately five minutes
- You can be awoken by a sharp sound
- All muscles slightly relax

39

- Your eyes slowly roll back and forth, not REM (Rapid Eye Movement – eyes jerking back and
forth under closed eyelids)
- Your thinking is less logical
- Your dreams are remembered if you awaken

Stage Two

- It is a little harder to awaken
- Two new types of brainwaves appear – sleep spindles and K-complexes. These occur regularly
and last only two to three seconds
- A sleep spindle is a sudden, short burst of pointed waves with frequency of 2/3 times (the
background of theta waves)
- K-complexes are large waves that seem to come out of nowhere, and are thought to reflect
massive changes in the processing of sensory information in the brain
- Most sleep talking and tooth-grinding takes place during this stage

Stage Three

- Occurs after another five to ten minutes
- You slip into moderately deep sleep
- It is now difficult to be awaken
- Delta waves; larger, more regular waves – come into play
- Theta waves, spindles, and K-complexes are still occurring, is harder to detect
- Delta waves become increasingly dominant

Stage Four

- Slow wave sleep
- The deepest level of sleep
- You are now extremely difficult to awaken
- All sleepwalking, bedwetting, and night terrors occur during this stage
- Your heartbeat and breathing are regular
- The growth hormone is released
- Blood cells and body tissue rebuild, especially your skin
- Energy levels are slowly restored
- There is no conscious thought
- Some dreaming, but you will have no memory of it if awoken

NOTE: Artificial sedatives significantly decrease REM sleep

Chronic Insomnia

Chronic insomnia may develop slowly or as a result of a long lasting emotional or physical situation that
has not been resolved. Four main factors need to be considered:

Psychological factors

- Anxiety
- Stress
- Arguments
- Depression

40

- Loneliness
- Grief
- Dissatisfaction
- Illnesses such as schizophrenia

Medical factors

- Heart disease
- Lung disease
- PMT
- Asthma
- Ear, nose, throat infections
- Thyroid functions

Chemical factors

- Side effects of prescribed medications
- Alcohol
- Tobacco
- Narcotics
- Caffeine (tea, coffee, cola, chocolate)

Sensitivities

- Allergies to foods, chemicals or mould
- With rare exceptions, insomnia is a symptom, not the cause. Consult your doctor

Caffeine

A strong stimulant that ultimately results in tiredness. Caffeine is found in coffee, tea, cola drinks,
chocolate and cocoa.

Alcohol
A depressant, alcohol may send you to sleep quickly but your sleep does not
reach the deeper delta levels and you are likely to awaken in the early hours or
sleep fitfully.

Nicotine

Another stimulant, nicotine raises blood pressure, alters breathing, and triggers adrenaline (which also
interferes with digestion)

Prescribed medication

Chemicals always have side effects, and a common one is sleep disturbance. Always check with your
doctor before changing or ceasing to use medications.

Starch, salt, sugar

All three can keep you awake

41

Some lucky people can sleep

anywhere….

Sleeping tips

- Keep your room dark
- Keep work out of your bedroom
- Don‟t read or chat on the phone in bed
- If you can‟t sleep, get up and do something mindless and/or repetitive –
- Get to bed at the same time every night
- Listen to soothing music
- Have a hot bath sprinkled with lavender oil
- Practice inhaling, holding for a count of ten, exhaling, holding for a count of ten, and keep doing
this until you feel tired
- Practise calming visualisations
- Gently massage your wrists and temples

42

Relaxation Practice Record
For each relaxation practice, indicate your anxiety/tension before you begin and again after you have
finished using the following scale.

0

10

20

30

40

50

60

70

80

90

100

No

Moderate

Severe

Tension/Anxiety

Tension/Anxiety

Tension/Anxiety

Practice 1

Practice 2

Day/Date

Anxiety/Tension
Before

Anxiety/Tension
After

Anxiety/Tension
Before

Anxiety/Tension
After

43

Basic Needs in life

SUN
FUN
MODERATION
GOOD FOOD
EXERCISE
AFFECTION
PHYSICAL SAFETY AND SECURITY
FINANCIAL SECURITY - ENOUGH TO MANAGE
FRIENDSHIP
BEING LISTENED TO
FEELING HEARD
GUIDANCE
RESPECT
VALIDATION
EXPRESSING FEELINGS: INCLUDING ANGER
SENSE OF BELONGING
NURTURING
INTIMACY
SEXUAL EXPRESSION
LOYALTY AND TRUST
SENSE OF ACHIEVEMENT
THE RIGHT TO BE WRONG
TO FEEL WORTHY
HOPE
SENSE OF FREEDOME AND INDEPENDENCE

NOT NECESSARILY IN THIS ORDER

44

PREVIOUS
EXPERIENCE

UPBRINGING

PARENTAL
INFLUENCE

PEERS

SCHOOL LIFE

SIBLING
RELATIONSHIPS

PRIOR TRAUMA

ILLNESS
RELIGIOSITY

MEMORIES

FUNDAMENTAL

THOUGHTS

ATTITUDES

BELIEF SYSTEMS

HOW YOU

INTERPRET

LIFE EVENTS

AND

SITUATIONS

HOW YOU

RESPOND

HOW YOU

THINK

AND/OR

FEEL

If you lack confidence and/or self-esteem…

EVENT

STIMULUS

LIFE

SOMEONE
SAYS
SOMETHING
TO YOU

SOMETHING
HAPPENS

OR

An idea or
memory is
triggered

YOU RESPOND

Eg.
Get Angry
Worry
Drink
Cry
Feel Bed
Have Bad
Thoughts
Etc
Etc
Etc
OR
You respond
appropriately

OR
You challenge that
thought

Internal
Control
Factors

MASTERY

External
Control
Factors

HELPLESS-
NESS

BECAUSE YOUR

INTERPRETATION

WAS

Belief
system was
faulty:
Everyone
hates me; is
talking about
me,
I SHOULD

………

I MUST BE

a good…

I am a

failure……
……………

EVENT

STIMULUS

PERSON

WHATEVER
HAPPENED

THINGS YOU
CAN
CONTROL

THINGS YOU

CAN‟T

CONTROL

MEMORIES

SOMEONE‟S

BEHAVIOUR

THOUGHTS
***********

FEELINGS
*********

IF THOUGHTS
ARE NEGATIVE,
HOPELESS,
FAULTY,
IRRATIONAL
OR IN ANY
WAY
DESTRUCTIVE
OR
UNHEALTHY....

CHALLENGE
THEM: LOOK
FOR OTHER
EXPLANATIONS

CHOSE:

CONTROL –

CHANGE

RESPONSE,

BEHAVIOUR.

AND
SUBSEQUENT
THOUGHTS AND
FEELINGS

YOU CAN‟T RESPOND WITHOUT HAVING SOME THOUGHTS/INTERPRETATIONS

WITH (OR TO BUILD) CONFIDENCE AND A HEALTHY SELF
ESTEEM

Getting Active

Activities consist of

Things you NEED to do
Things you WANT to do
AND things you can „get around to‟ if and when you feel like it……

WHEN DEPRESSED YOU DON‟T FEEL LIKE DOING MUCH SO YOU HAVE
TO FORCE YOURSELF TO DO SOME THINGS
– Often you end up feeling a sense
of achievement that you actually got SOMETHING done!

EXERCISE: Plan your day/week or if that‟s TOO hard start with planning the next few

hours:

BREAK IT UP into:

Pleasure activities……(it is essential to incorporate pleasure/leisure/fun activities into

everyday)

Daily living requirements……At first this may just be getting up, showering and
eating…

Longer term living requirements…eg: paying bills, making phone calls, organising your
life…

SO!!!!!!!!!

Start NOW! Your first activity is TO DO THIS EXERCISE!

IF YOU WAIT UNTIL YOU FEEL LIKE DOING IT, IT WONT GET DONE!
So encourage yourself NOW!

Day 1

ACTIVITY

CATEGORY (Pleasure or what??) % COMPLETE

LEVEL OF
SATISFACTION

TRY AND HAVE A BALANCE BETWEEN THINGS YOU HAVE TO DO, THINGS YOU WANT TO DO AND THINGS THAT ARE

GOOD FOR YOU TO DO

51

NEGATIVE THOUGHTS ARE ACTIVITY BLOCKERS……THOUGHTS

SUCH AS..

NO POINT IN TRYING
NOT GOOD ENOUGH
NOT SMART ENOUGH
ETC ETC ETC

SELF DEFEATING FEELINGS AND THOUGHT LEAVE YOU
DISCOURAGED.FEELING INADEQUATE, HELPLESS, HOPELESS,
AND USELESS!!!

THIS RESULTS IN DISINTEREST POOR MOTIVATION AND MORE
DEPRESSION

Normal Moods:

Moods are an important part of our everyday experiences and add

certain richness to our quality of life. From time to time everyone

feels “down” or “fed-up” or “out of sorts.” Sadness, concern,

disappointment and annoyance can be useful emotional responses in

situations that didn‟t turn out the way you would have liked them to.

These feelings are often an indication that some effort is required to

re-adjust or that something constructive must be done to deal with

your feeling or to change the situation. Start using your “stress

energy”

52

Keeping a Mood Diary……

When we feel depressed, our view of the world tends to be
darker and we are more likely to recall low feelings
rather than happy feelings. Sometimes when people are
depressed, they find it difficult to recall how they felt on a
particular day last week, for instance. They also find it
hard sometimes to gauge whether their mood is
improving or not and what events trigger changes in
mood.

Keeping a mood diary for a few days a week doesn’t take

too much time or work and it gives a much more accurate

measure of how you’ve been feeling at different times of

the day on different days of the week.

A mood diary will also assist in measuring change in
your feelings over a longer period of time – perhaps weeks
or months. This gives us an idea of whether your
depression is lessening.

What to do:

Three times each day, take 5 minutes to rate your
mood and anxiety level. Try to keep it to the same
time e.g. after breakfast, before lunch etc.
If there has been something significant about your
day, write it down.
If you miss a time or miss a whole day – don’t worry,
just continue with the next rating time.
The most important part of this activity is to report

How you feel at that particular time.

53

ANXIETY & DEPRESSION

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