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Anxiety Self - Management

I. Diaphragmatic breathing:
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“Diaphragmatic breathing” also known as “Belly breathing” and “Abdominal breathing” is defined as an efficient integrative body–mind training for dealing with stress and psychosomatic conditions. 

Benefits: 

  • Decreases stress hormone (Cortisol)

  • Improves Blood flow and blood gases 

  • Improves attention and concentration 

  • Decreases heart rate and blood pressure 

  • Decreases muscle tension 

  • Increases energy and motivation 

  • Decreases stress and anxiety 

Practice method: 

  • Sit or lie in a comfortable place. Close your eyes.

  • Place one hand on your chest and one hand on your abdomen. The bottom hand should do the moving. The top hand should remain still or only move as the bottom hand moves.

  • Inhale through your nose for about 5 seconds, feeling your abdomen expand. (You may feel slight tension the first few times you inhale.)

  • Hold your breath for 2 seconds.

  • Exhale very slowly and steadily through your mouth for about 5 seconds. The mouth should be relaxed.

When to practice:

Diaphragmatic breathing can be done anywhere and anytime, more importantly, it can be done when you are feeling increasingly stressed. It is beneficial if practiced at least twice a day for 5 minutes. 

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II. Progressive Muscle Relaxation:

Progressive muscle relaxation is based upon the simple practice of tensing, or tightening, one muscle group at a time followed by a relaxation phase with the release of the tension thereby reducing stress and anxiety in your body. It is a direct way to address the flight/ fight/ freeze symptoms.

Benefits: 

  • Develop a feeling of well being 

  • Lower the blood pressure 

  • Decrease muscle tension 

  • Decrease the body's need for oxygen 

  • Reducing fatigue 

  • Decrease stress and anxiety 

Practice method: 

  • While inhaling, contract one muscle group (for example your upper thighs) for 5 seconds to 10 seconds, then exhale and suddenly release the tension in that muscle group.

  • Give yourself 10 seconds to 20 seconds to relax, and then move on to the next muscle group (for example your buttocks).

  •  While releasing the tension, try to focus on the changes you feel when the muscle group is relaxed. Imagery may be helpful in conjunction with the release of tension, such as imagining that stressful feelings are flowing out of your body as you relax each muscle group.

  •  Gradually work your way up the body contracting and relaxing muscle groups.

  • Here's a link to a youtube video (Channel name: Mark Connelly) for your proper guidance.

When to practice:

The PMR exercise takes around 15 minutes to complete. Although efficient, it requires a private and peaceful environment. It can be practiced once or twice a day at home. 

III. Mindfulness of Breathing (Anapana Sati):


Anapana Sati aka mindfulness of breathing means the mindfulness established on an object all the time with each in and out breath. Ana = incoming breath; Apana = outgoing breath; Sati = awareness. (Awareness of incoming and outgoing breath).

Benefits: 

  • Concentration, awareness, and alertness of mind improve. 

  • Decision-making power improves.

  • Self-confidence improves. 

  • Agitation, nervousness, stress, tension, and fear decreases.

  • Better performance in studies, sports, and extra-curricular activities.

  • The mind becomes healthy, wholesome, and strong. 

  • One becomes full of good wishes for others. 

Practice method: 

  • Sit comfortably keeping your waist, back, and neck straight.

  • Keep your eyes and mouth gently closed.

  • Remove your spectacles (for those who wear them).

  • Focus your entire attention on the entrance of your nostrils. 

  • Remain aware of the natural breath as it comes in, as it goes out.

  • Don't try to control the count or regulate the breath. 

  • Don't add any word or mantra - verbalization, or imagination of any kind.

  • When the mind wanders away, bring it back to awareness of respiration.

  • Try to remain aware of each and every breath that comes in and goes out.

When to Practice:

For getting full benefits, it is necessary to practice anapana for 10 - 15 minutes twice a day (morning and evening).

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IV. Psychotherapy:
 

One of the most commonly used therapy methods for anxiety control is Cognitive behavioral therapy (CBT). American Psychological Association defines CBT as a form of psychological treatment that has been demonstrated to be effective for a range of problems including depression, anxiety disorders, alcohol, and drug use problems, marital problems, eating disorders, and severe mental illness. Many studies have proven that CBT is as effective as psychiatric medications. Although, both psychiatric medications and psychotherapy have a synergistic effect when provided together and have a better and quicker outcome than any of them alone. 

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CBT usually involves efforts to change thinking and behavioral patterns. It is based on several core principles, including: 

  1. Psychological problems are based, in part, on faulty or unhelpful ways of thinking.

  2. Psychological problems are based, in part, on learned patterns of unhelpful behavior.

  3. People suffering from psychological problems can learn better ways of coping, relieving their symptoms, and becoming more effective in their lives.

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CBT is usually provided by a certified psychotherapist or a psychiatrist. The number of follow-up visits and the need for CBT are decided by the providing therapist based on the severity of the condition.

V. Kirtan Kriya:
 

“Kirtan Kriya” also known as “Sa Ta Na Ma Meditation” is becoming scientifically recognized as a powerful tool for preventing or stopping Alzheimer's disease, increasing cognitive functions (perception, thinking, reasoning, and remembering), and reducing stress levels while improving short-term memory. 

Benefits:

  • Improves memory power

  • Prevents Alzheimer's disease 

  • Helps manage stress and eliminates brain fog

  • Good for sleep and cures insomnia

  • Helps in emotional healing and improves clarity 

  • Makes you calm and cheerful

Practice method:

  • Repeat the Saa Taa Naa Maa sounds (or mantra) while sitting with your spine straight. Your focus of concentration is the L form, while your eyes are closed. With each syllable, imagine the sound flowing in through the top of your head and out the middle of your forehead (your third eye point).

  • For two minutes, sing in your normal voice.

  • For the next two minutes, sing in a whisper.

  • For the next four minutes, say the sound silently to yourself.

  • Then reverse the order, whispering for two minutes, and then out loud for two minutes, for a total of twelve minutes.

  • To come out of the exercise, inhale very deeply, stretch your hands above your head, and then bring them down slowly in a sweeping motion as you exhale.

The mudras, or finger positions, are very important in this kriya (as shown in the image).

  • On Saa, touch the index fingers of each hand to your thumbs.

  • On Taa, touch your middle fingers to your thumbs.

  • On Naa, touch your ring fingers to your thumbs.

  • On Maa, touch your little fingers to your thumbs.

Heres a link to a youtube video on (Channel name: Nina Mongendre) for your proper guidance. 

When to practice:

Kirtan Kriya requires a calm and peaceful environment and requires at least 15 minutes for a proper meditation session. Can be done once a day and is more beneficial if done at the beginning of the day.

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VI. Hand Warming Exercise:
 

This practice involves learning how to warm your hands using the imagination of your brain. 
Concept: 
Whenever a person feels stressed and anxious, there is sympathetic hyperactivity. This sympathetic hyperactivity leads to increased heart rate, blood pressure, cold hands and feet, hand tremors, tensed muscles, increased respiratory rate, and gastric distress. Hand warming is a technique is a method which can be used to reduce sympathetic hyperactivity and the above-mentioned symptoms. This would help decrease hyperactivity and increase parasympathetic activity which has the opposite effect and helps a person relax. 
Practice Method: 
Whenever facing such a situation of sympathetic hyperactivity, a person can sit in a comfortable position, close their eyes and imagine themselves in different scenarios such as holding a hot cup of tea, sitting around a relaxing bonfire, touching their partner’s warm skin, sitting on a beach on a sunny day, etc. After practicing this method for just 5 minutes a person feels relaxed, and the blood pressure and heart rate lower with a sense of clarity in mind.

VII. ANT Therapy:
 

I came across the “ANT therapy” or “Automated Negative Thought Therapy” in a book called “ Change your Brain Change your Life, written by Dr. Danial Amen. I have practiced ANT therapy with my patients and have gained some valuable positive results. Below is the summary of the same.

In simple words a person has to analyze their negative thoughts which are automatic in nature and try to stop them by identifying the type of thought, writing them down and come up with a logical solution to such negative thoughts. 

Types of ANT: 

  1. All-or-nothing thinking: thoughts that things are all good or all bad.

  2. “Always” thinking: thinking in words like always, never, no way, everyone, or everything. 

  3. Focusing on negative: only seeing the bad in a situation.

  4. Fortune telling: Predicting the worst possible outcome to a situation with little or no evidence for it.

  5. Mind reading: Believing you know what other person is thinking even though they haven't told you.

  6. Thinking with your feelings: Believing negative feelings without ever questioning them. 

  7. Guilt building: Thinking in words like should, must, ought, or have to. 

  8. Labeling: Attaching a negative label to yourself or to someone else. 

  9. Blaming: Blaming someone else for the problems you have. 

For example: 

ANT: My boss dosen't like me. 

Type of ANT: Mind reading ANT

Kill the ANT: I don't know that. Maybe she is just having a bad day. Bosses are people too. 

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VIII. Lifestyle modifications:
 

​1. Stay away from substance abuse:

The use of illegal drugs or the use of prescription or over-the-counter drugs or alcohol for purposes other than those for which they are meant to be used, or in excessive amounts. Substance abuse may lead to social, physical, emotional, and job-related problems. Such substances are often consumed to get a quick fix for underlying psychological problems.

The vicious cycle of alcohol and other illegal substances in different scenarios:

  • Sleep disturbance: many people who are unaware of the harmful effects of alcohol or other substances consume them for a quick fix for falling asleep. 

  • Depression and sadness: many patients who feel depressed and sad consume substances for a quick fix to elevate and elate their mood. 

  • Anxiety and stress: Many people with anxiety and stress consume such substances for a quick fix to calm themselves and reduce the sympathetic hyperactivity of their bodies.

  • There is a tolerance that develops to such substances and the person requires more and more amount of such substances to achieve the same effect, which later leads to dependence. 

There are healthy ways to handle stress, sadness, and sleep disturbances. Evaluate yourself and the people surrounding you for addiction and seek professional help.

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2. Limit smartphone use:

Smartphone addiction sometimes referred to as problematic mobile phone use, is a behavioral addiction thought to be similar to that of internet, gambling, shopping, or, video game addiction and leads to severe impairment or distress in one’s life. Problematic smartphone use can lead to credit card misuse and compulsive shopping online. Moreover, there is a risk of developing social media addiction, leading to poor self-esteem, poor performance at work, and interpersonal conflicts. The commonest habit of scrolling through social media before going to bed also leads to interrupted and poor quality of sleep leading to daytime sleepiness and fatigue.

It is important to identify this behavior and limit smartphone use to less than 2 hours per day. 

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3. Practice your religion:

Having and practicing religion provides a person with a sense of faith and something to believe in. Some of the psychological benefits of practicing religion are: Helps a person to stay calm, decreases craving and addiction tendencies, reduces suicidal tendencies, and develops a sense of well-being.

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