Dealing with anxiety in uncertain times

Some people (lots of people, most people) are having some struggles at the moment. My wonderful wife Jennifer Heazlewood who is a doctor has been helping people with this and has put together some notes and links below that some of you might find useful.

In many who are experiencing anxiety, there may be avoidance of seeking help due to perceived stigma or the fear of a label. These patients would benefit from us normalising anxiety. We all experience anxious times in our lives. We all have mental health. Sometimes our mental health is good and sometimes it is not so good. We should look after our mental health just as much as our physical health. Acknowledging and accepting when our mental health needs prioritisation is the first step.

If you are needing some support, there is an abundance of resources out there on the web and in social media. It's important to find something you think you can realistically do for self help/relaxation and try to make this a priority in your daily routine. Not everything suits everyone. Like any lifestyle advice we are only going to be able to stick with a new change if it is something that works for us. I advise patients: try to stick with whatever self help tool you choose it as it is likely you will need to practice it. If you've lived with anxiety for for a while, it might not come naturally. Think of it as choosing to feed/nurture the parts of the brain (the limbic system) that allows you to be more present and happy and allows the higher cognitive functions of the brain to work optimally (controlling emotions, concentration, rational thinking etc). Ignoring anxious tendencies is not a great option as we tend to get more and more practiced at being anxious. It becomes subconscious. It becomes a habit. Essentially we are feeding/nurturing the 'fight-flight' part of the brain (the amygdala) . The 'fight-flight' part of the brain is overworking in someone who tends to be anxious. The 'fight-flight' reaction is a NORMAL physiological reaction. It's necessary for human survival but it doesn't serve us well when it switches on too readily because when we are in 'fight-flight' mode we can't be 'in the moment', we can't therefore relax or get as much joy from things as we used too. The frontal cortex of the brain (the bit that controls the higher cognitive functions like planning, concentration, emotion regulation, rational thinking etc) doesn't work well when we are in 'fight-flight' mode. 

There is the option of professional psychotherapy too. Sometimes this is an easier option if we are already feeling overwhelmed as trawling though endless online resources can sometimes be hard to navigate. I personally believe we all could benefit from psychotherapy at some stage in our lives to identify our negative thinking habits, triggers etc and train ourselves to be more accepting of ourselves and allow us to change or manage some behaviours. The sooner we destigmatize 'therapy' and mental health issues the better. 

Mindfulness is a trendy word at present. Anxious people often feel they can't 'do' mindfulness as they associate it with the idea of meditating for hours. This is not something that's going to come naturally to someone who is hypervigilent or 'busy-brained'! I like the following definition of mindfulness: Mindfulness is about strengthening the attention muscle and the ‘bringing back’ muscle (neuroplasticity). It's about being present in and enjoying the moment, doing one thing at a time, without judgement. It is the opposite of ruminative thinking or mindlessness (e.g. endless hours of flicking through Facebook). Essentially mindfulness can be practiced in MANY different ways. It does not necessarily involve sitting cross legged trying desperately to stop your thoughts!

One mindfulness practice I like is, to STOP, just for a few minutes and just NOTICE your thoughts. Think of them like traffic in your head. Don't judge the thoughts or try to chase them. Don't jump into the middle of the traffic but instead choose to stand on the side of the road and watch them. It's often very enlightening just noticing how busy our brains can be. Noticing allows room for change. You may be able to choose to ignore some of the thoughts potentially or you might be motivated to practice relaxation techniques. Relaxation can take whatever form you prefer: breathing, exercising, progressive muscular relaxation, short guided mediations/visualisations or just being in the moment for snippets of time for example, whilst out walking focus on one of your senses (what you can hear or see or how your feet feel on the ground) as this helpd to anchor us in the moment. Another way to distract from the automatic ‘fight-flight’ reaction is to stand on one leg. It’s difficult for the ‘fight-flight’ part of the brain to be working whilst our balance part of the brain (our cerebellum) is working hard!

Another option is medication. This should not be the first and only option of course. Medication is often not necessary but is a helpful addition sometimes. It is very appropriate (with specialist input) for more severe cases. It can perhaps be thought of as a crutch to make some of the self help work easier.

It is important to consult a doctor for a full assessment if symptoms are difficult or not improving with self help. The doctor may arrange some tests to rule out any contributing physical problems such as thyroid issues or anaemia.  The doctor will take a thorough history, provide ‘safety nets’ (options to keen you safe and ensure follow up or more support if needed), give regional specific resources/referral options etc

Useful resouces for anxiety tendencies:

·  www.calm.auckland.ac.nz -listen to some of the downloads

· www.headspace.org.nz. Headspace also have a great App

· www.mentalhealth.org.nz .

· www.moodgym.anu.edu.au

· www.actmindfully.com.au

· www.thiswayup.org.au 

· www.moodcafe.co.uk

· www.justathought.co.nz/ 

· Helpline: Free call or text 1737 any time for support from trained counsellor

· Helpline: 0800ANXIETY (0800 269 4389)

· Book: "finding peace in a frantic world" by Danny Penman and Mark Williams

· Book: “self compassion. Stop beating yourself up and leave insecurity behind” Kristin Neff

· Book: Overcoming anxiety by Helen Kennerley (CBT approach)

· Courses: there's bound to be local courses on mindfulness or other forms of relaxation 

· Apps: 'smiling mind' app is v simple, short guided meditations and great for kids too 

· Other Apps: Anxiety Release, Headspace

· And a great resources for coronovirus specific anxiety: https://www.actmindfully.com.au/wp-content/uploads/2020/03/FACE-COVID-eBook-by-Russ-Harris-March-2020.pdf