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My Story - 19/11-2007

I have suffered with anxiety all my life but it really started taking over my life about 3 months ago when my wife found a dead mouse in our brand new deep fryer. It had somehow lifted the top off of the oil container, crawled in and drowned.
I did everything, put out traps, called the exterminator. The exterminator told us we had nothing to worry about and that our infestation was very minor. He did his thing and it seems to have worked as there are no more signs of mice anywhere (no droppings, messes, etc).
However, even though I know in my heart that we have no more mice (trust me, I've checked every knuck and crammy and haven't found any sign whatsoever), I cannot shake the thought that they are there and that I have to get them. I am always on guard for them and hate leaving the house because, in my head, while I am there I am keeping them at bay.
Please be aware, I am not afraid of the mice. For me it has to do more with the fact that they got in in the first place. I lost the control of what can come in my house and what can't when we found we had mice and my anxiety is caused by this. Until I am secure that I have regained the control and that I have convinced my mind that I have eliminated the intrusion, I will continue to feel anxious about it.
I realize it will take some time. Buy I am determined to beat this. M.

Panic attacks and heart attacks - 02/10/2007

I have been made aware recently of a study that was in the news about a link between panic attacks and the development of heart attacks and strokes. I know that this is causing some concern among members of the anxiety forums so I did a bit of digging and this is what I found out...

Firstly, all the research was done on post-menopausal women so age is a determining factor.

Secondly, when they say you are "twice as likely to have a heart attack or stroke in the next five years" they are not talking about 80% compared to 40%, they are talking about 4% compared to 2%. In a sample of 3369 women, this could easily be circumstantial.

Thirdly, the results were altered to factor in other health problems, none of which were detailed in the news reports.

And finally, the research was carried out by GlaxoSmithKline, a leading manufacturer of anti-anxiety medication and the same company that was responsible for distorting the reports linking Seroxat (one of their brands) to teenage suicides.

These are facts; draw your own conclusions.

A worried parent - 04/09/2007

The following paragraph is from an email I received the other day. If you have any experience of dealing with anxiety in your children or if you can offer any advice, please mail us here and we will pass it on. Thanks.

My son is 13 years of age and he has been having panic attacks since the age of 5. He goes through goods stages where he can cope with anything, but on the other hand he goes through stages where he can cope with nothing. At the moment he is off school and hasn't got the routine in his life and it always sets him back. At the moment he has to be with someone 24 hours a day. He doesn't sleep won't go outside alone all he wants to do is play on his computer. We, as the parents have tried lots of different things which always include lots of support and encouragement but this time he seems really bad. Since he was 5 he has seen a range of different doctors but none have helped much. What I am looking for really is some hope that one day my son will be able to live a normal life and be happy, as he has missed out on so much already. If anyone as any suggestions, please post them on. Thanks.

Anxiety and Panic, FAQs - 20/08/2007

Here are some frequently asked questions about anxiety and panic attacks...

What is the difference between Anxiety and Panic attacks?

In truth there is no hard and fast boundary between anxiety and panic. In general, anxiety is a term applied to a heightened state of fear and is applied to your "background" state, whereas panic describes a rapid onset or worsening of anxiety. Everybody experiences a degree of anxiety at certain times in their life but if this anxiety persists at times when there is no discernible danger, it is described as an anxiety disorder. If a person experiences a sudden debilitating surge in anxiety when there is no discernible danger, it is termed a panic attack.

Can I die from a Panic Attack?

The biological changes that happen when you suffer a panic attack are similar to the changes brought on by physical exercise. The heart-rate, respiratory-rate and blood-pressure increase temporarily and you may experience digestive discomfort, muscle tension, shaking, sweating and a sense of detachment from your surroundings. For anyone with a serious heart condition, these temporary changes could possibly trigger a heart attack but there is no evidence to suggest that the symptoms are damaging to an average individual. Anxiety certainly does not cause heart problems. Your doctor will be able to advise you of any existing conditions you may have that could be affected by anxiety.

Can I go mad because of Anxiety?

No. There is a huge difference between the confusion, detachment and frustration that anxiety sufferers can experience and serious mental conditions that you might term as "madness". It is very common for anxiety sufferers to feel like they are going mad or to have disturbing thoughts or behavioural quirks. As a general rule, if you are worried about going mad, you are not.

What are Social Phobia and Agoraphobia?

Social phobia is an irrational fear of being in social situations that could prove embarrassing or difficult to escape from. Like any phobia, there are varying degrees of social phobia and because of this, some people can handle some social gatherings but not others. Situations where you may become the centre of attention can be particularly daunting. Agoraphobia sometimes encompasses the problems of social phobia but can also apply to outdoor places or unfamiliar places that may or may not be busy. Most agoraphobia sufferers have a number of "safe places" and they feel discomfort when forced outside these places.

What can I do about my anxiety?

There are various approaches to tackling anxiety and nobody can say which one is right for you. Some people react well to medication and some people respond better to talking therapies, but there are some ground rules that will help, whoever you are...

Take a look at your lifestyle. Eat plenty of fruit and vegetables to keep up your vitamin levels and get into a regular sleeping routine. Avoid alcohol and caffeine and also consider the impact of nicotine or any recreational drugs. Drink plenty of water.

Be organised. Write things down rather than trying to remember them. Organise your life to minimise stress and allow time for regular relaxation - even if it is just watching the TV or listening to music.

Be disciplined. Set yourself targets every day and STICK TO THEM - even if they are only simple things. Think about practical steps that will challenge your anxiety. If you can only walk 100 yards down the street, set yourself a target to walk 110 yards next time.

Be realistic. Accept that what you are feeling is fear, NOT DANGER. Try to come to terms with the anxiety and stop thinking that you are stupid or weak for experiencing it. Don't worry about the physical symptoms of anxiety, they are perfectly normal biological responses. If in doubt, look for PROOF, not hunches.

Be brave. Don't be scared of fear. You will not come to terms with anxiety unless you allow yourself to get into situations where you will experience it. Think to yourself "come on anxiety, do your worst".

Do you have a question about anxiety? Mail us and we'll do our best to answer.

Physical causes of anxiety

There are a number of physical causes that could be causing or contributing to your panic attacks:
• Unstable blood sugar levels (hypoglycaemia) can be the result of poor eating habits, dieting and fasting.
• Over-breathing (hyperventilation) happens when you are under stress, though you may not be aware of it. Your breathing becomes more rapid, in order to meet the body's demand for more oxygen for the muscles. As a result, you breathe out more carbon-dioxide than normal, which can bring on panic symptoms.
• Digestive problems, particularly food allergies, may be to blame.
• Taking antidepressants, particularly the newer ones, may produce panic attacks, especially at first.
• Caffeine, cigarettes, alcohol, and certain street drugs (such as, LSD, marijuana and cocaine) can bring on a panic reaction.
• Withdrawing from any drug that has a sedative effect, such as nicotine, alcohol and tranquillisers, can do the same.
• Some prescription medication, including some amphetamines, steroids, anti-asthma drugs, and even nasal decongestants have been reported to increase anxiety.
• Sometimes, problems with the way the brain works (known as organic brain dysfunction) will cause balance, coordination and visual difficulties that make people very vulnerable to stress, and may contribute to agoraphobia.
• Being in chronic pain can be another cause of panic attacks, as can simple jet lag.

(extract from How to Cope with Panic Attacks from the MIND mental health charity. Click link to view complete document)

Charity begins at (my) home (page)...

A summary of anxiety and phobia related charities in the UK...

anxietycare.org.uk Helpline (020) 8478 3400 (open Mondays and Wednesdays, 10am to 3pm)

sane.org.uk Helpline 0845 767 8000

mind.org.uk Information Line 0845 766 0163

changes.org.uk Helpline 01782 289592

phobics-society.org.uk Helpline 0870 122 2325

anxietyalliance.org.uk Helpline 01926 851608

nopanic.org.uk Helpline (freephone) 0808 808 0545 (10am to 10pm) - Answer phone advice available on same number, 10pm to 10am

An appeal from Michael Braithwaite of Flame TV.

Michael is looking for individuals who suffer from ablutophobia (a fear of washing) or who find that their anxiety issues have led to difficulties in maintaining personal hygiene.

If you feel that your circumstances or previous experiences would be of interest to Michael. please contact him directly on 0207 713 6868 or by email at michael@flametv.co.uk

The Paradox of Anxiety and Alcohol Misuse (extract from Mental Health and Alcohol Misuse factsheet from Alcohol Concern)

While anxiety and alcohol consumption are interlinked, the question of which condition precedes the other is dependent on a range of factors, including; the amount of alcohol consumed (that is, use or misuse of alcohol), the duration of alcohol misuse, and whether or not a person has a diagnosed anxiety disorder or is merely showing the symptoms of anxiety.

There is a widespread belief that alcohol can act as an anxiolytic that is, alcohol can help to dispel feelings of anxiety. For example, many socially anxious people believe that alcohol may reduce social anxiety, helping them to feel more comfortable in social situations (Book & Randall 2002).

Although alcohol is a fast-acting anxiolytic that may temporarily relieve feelings of anxiety, long-term alcohol misuse and acute alcohol withdrawal often increase anxiety levels (cf. Lingford-Hughes et al. 2002; Trevisan et al. 1998; Modesto-Lowe & Kranzler 1999). For this reason, alcohol may be consumed in increasing quantities by people with a drinking problem, embroiling them in a vicious cycle; drinking to self-medicate their anxiety, but in so doing, furthering their anxiety in the long-term (Lingford-Hughes et al. 2002).

Download full document

Extract from Coping with Worry and Anxiety by Ed and Cecilia Beckham - 27/07/2007

When persons are anxious, their minds are more likely to focus on dangerous and threatening situations. It becomes more difficult to think in a purely about neutral and positive information which is available. In addition, events which are not clearly either safe or harmful (ambiguous) are more likely to be interpreted by the mind as dangerous. This makes sense if the purpose of anxiety is considered. Anxiety is meant to help preserve the individual in dangerous situations. When faced with an ambiguous situation (“Is this is a stick or a snake? Is this harmful or not harmful?”), which interpretation is most likely to get the individual killed? Mistaking a dangerous animal for a non-dangerous one. Once the brain decides that a dangerous situation may be present and a state of anxiety is created, it quits being objective. It is willing to make a mistake on the side of caution. However, once anxiety becomes chronic and continues a particular danger, the usefulness of this mechanism is lost. Now, everything seems to be dangerous, and the person begins to avoid too many situations...

Click here to download the whole document (pdf format)

Cognitive Behavioural Therapy 3 - 24/07/2007

Thoughts that you hold in your conscious mind, no matter how well intentioned, are easily forgotten, distorted or replaced by other, more damaging thoughts. For this reason, a therapist may well get you into the habit of writing things down. Once you write it down it can't be changed or deleted so easily; it remains constant.

Panic Diary

Keeping a panic diary is quite an effective way to document and challenge your negative thoughts. Here is an example:

Situation and Thoughts	Emotions (rate)	Evidence to support thoughts	Evidence against thoughts	More sensible thought	Re-rate emotions
What were you doing? What did you think about?	What emotion(s) do you feel and how severe?	What proof* have you got that the thoughts might be true*	What proof* have you got that the thoughts might not be true*	What is a more likely scenario? What would you say to a friend in this position?	Has the emotion changed in severity?
Watching a television program about hospitals, started getting strange pain in my chest Might be having a heart attack	Anxiety 60%	Sensation in my chest	I have felt this hundreds of times before and I have never had any health problems Anxiety does cause strange sensations in your chest	Watching the program about hospitals has triggered anxiety and it is the effects of anxiety that are causing the strange sensation in my chest	40%

In the example above, there is a reduction in anxiety from 60% to 40% but don't be discouraged if you don't experience this drop in anxiety yourself; it is still worth writing things down. Make sure you label each episode with a time and date so that you can look back in the future and see that days, months or even years have passed since an event that you thought was life-threatening, and you are still fit and well.

Worry List

Another example of how writing things down can help is keeping a worry list. It is much easier, once you have written something down, to forget about it and not feel compelled to keep that worry in your conscious mind. Think of it like putting money in your bank - you still have the money and you can get it any time you want but you don't have the responsibility of carrying it around with you.

One of the huge psychological burdens on your mind when you worry obsessively is feeling the need to remember everything that 'needs' to be worried about or being afraid that you will forget something important. Writing your worries down ensures that they are not forgotten.

If you are technically minded enough, you can even set up a system of reminders using software such as Microsoft Outlook, to remind you when a situation needs to be addressed.

Cognitive Behavioural Therapy 2 - 22/07/2007

After tackling our evasive actions, the next step might be to challenge the way we think about certain situations. Our thoughts can become very patterned and habitual so it takes a lot of practice to change them. Because of this, it is better to practice at times when you are not anxious in order to prepare yourself for the times when you are - you would never take an amateur footballer and try to train him during the FA Cup final.

If we take an average agoraphobia sufferer, they might have the following thought when faced with walking down the street:

I might collapse.

The first thing to do is to get them to recognise that this is only a thought, not a fact. So then it becomes:

I THINK I might collapse.

Now somewhere inside their mind they will have a reason (or a number of reasons) for thinking this and these will usually be subjective (based on feelings) rather then objective (based on fact). If we add their subjective justification we might get:

I think I might collapse BECAUSE I feel light-headed and faint.

Now if we add some objective reasoning, the thought might become:

I think I might collapse because I feel light-headed and faint BUT it is very unusual to faint through anxiety and it has never happened before.

Now we can subtract the harmful subjective justification we can see that the danger element only exists in our feelings or hunches:

I think I might collapse but it is very unusual to faint through anxiety and it has never happened before.

We can then compare this to something else that is very unusual and has never happened before to see how ridiculous it is:

I think I might be run over by a stampeding donkey but it is very unusual and it has never happened before.

At this point, if you develop an acute fear of stampeding donkeys, you know the therapy isn't working. Assuming you don't, we can then look at a number of ways to word this:

I am ANTICIPATING something that is VERY UNLIKELY to happen and has NEVER happened before.

I am MISTAKENLY anticipating something.

I am WORRYING over NOTHING.

You'll notice from the above example that the sentence structure for a negative statement is I am worried BECAUSE feelings (subjective) BUT facts (objective)... We can turn this round for a positive statement and write I am looking forward to this BECAUSE facts (objective) BUT feelings (subjective)...

I think I will enjoy this walk BECAUSE the sun is out and the scenery is great BUT I think I might faint.

...and again, if we drop the subjective part of the statement...

I think I will enjoy this walk because the sun is out and the scenery is great.

Remember, facts are what IS happening, feelings are what you think MIGHT happen. If everybody was guided by their fears of what might happen, nobody would ever board an aeroplane or cross a road or anything, and if everybody knew exactly what was going to happen, there would be no enjoyment or excitement in life - and all the bookmakers and casinos would go out of business.

What is Cognitive Behavioural Therapy? 21/07/2007

Cognitive Behavioural Therapy (CBT) is a system of counselling that attempts to focus the subject's attention on the way they think about things that affect them and the behaviours they exhibit which can affect their thoughts and emotions. (The subject is the person receiving the therapy). The therapy concentrates on the "here and now" and aims to bring fears into the context of the present moment and prevent the subject from always thinking about possible future consequences.

It has been found to be helpful in tacking the following problems:
Anxiety
Depression
Panic
Phobias
Obsessive Compulsive Disorder
Post-traumatic Stress
Schizophrenia

Problems can usually be broken down into manageable components and CBT is a method of identifying the situation in isolation and recognising how you feel and think about the situation, how it makes you feel physically and how you react to the situation. For example, someone who experiences fear every time there is a knock at the door would learn that the knock at the door, on its own, is not the cause of the fear, it is a combination of their own reaction to the knock at the door, along with the thoughts and feelings that accompany it. There is an equation that therapists like to use:

E + R = O (Event + Reaction = Outcome)

In other words, an event can not be scary until combined with our own reactions.

For any given event, there can be an infinite number of reactions (thoughts, feelings and actions) and an infinite number of outcomes. Imagine you are sitting in the house alone at night and there is a loud clap of thunder outside. Two different people may have these different reactions:

A) Oh no, it's thundering. I hate thunder. I'm so scared.

B) Great. I love thunderstorms. Hope it's a long one.

The physical event is exactly the same for both people but person A has a negative reaction and generates negative thoughts, whereas person B generates positive thoughts. This will have a knock-on effect on their emotions and actions. Person A might hide under the bed-covers whereas Person B might run to the window to watch the lightning - still nothing has changed in the actual event.

Of course the reactions to these events can happen so quickly or be so habitual that they escape our conscious minds and the aim of the therapy is to give the subject the ability to recognise them and address them. Let's look more closely at the reactions of person A and person B in the thunderstorm:

	Person A	Person B
Thoughts	Thunderstorms are dangerous	Thunderstorms are spectacular
Emotions	Fear	Excitement
Actions	Hiding	Watching

Because person A gains a perception of safety from hiding, it reinforces their belief that the thunderstorm (and not hiding from it) equals danger. Person B reinforces their belief that thunderstorms are exciting. Again, I will stress that the actual event is exactly the same for both people and person A is in no more danger than person B.

Person A may well experience further anxiety because of the way their own body reacts to the perception of danger. They may feel an increase in their heart-rate or start to sweat, and these physical reactions may well add to their fears and become associated with the thunderstorm.

Of the three reactions (thoughts, emotions and actions), actions are the easiest to change because we have the greatest degree of conscious control over them, so the first stage would be to get person A to see how futile the act of hiding is and see that they can be just as safe if they don't perform this action.

...to be continued...

TFT and EFT - 18/07/2007

Anyone who has browsed the internet looking for solutions for their anxiety issues has probably come across TFT and EFT.

TFT (Thought Field Therapy) is a therapy that supposedly works by interrupting certain electrical fields by a process of tapping on certain acupressure points on the body whilst concentrating on the object of your phobia. These tapping points have been mapped out in algorithms by the founder, Dr Callahan.

EFT is a variation of this that does away with the algorithms and goes for a catch-all, tap-all-over approach.

Personally I think these claims are a load of rubbish and in all the years I have been corresponding with anxiety sufferers, I have yet to meet one person that has benefited from either form of this therapy. Come on, how can tapping your armpit stop you being afraid of spiders; it's beyond belief? And as for electrical fields, if that was the case, we'd all start to think differently every time we walked past the television.

The worrying thing is, these methods are advocated by people like Paul McKenna, who I always thought had his head screwed on. Is he cashing in on the big TFT/EFT bandwagon somehow?

What makes me angry about these claims is that they prey on - and in the case of people like Lawrence Leyton, charge money to - people who are in a very vulnerable position. They offer false hope with outlandish claims, none of which have a shred of objective evidence to back them up.

I would love to be proved wrong. If you have been cured of a phobia by EFT or TFT, send me a mail here. I'll bet my bottom dollar I don't get one mail.

Forums - 16/07/2007

From my own experiences with anxiety, I know that one of the most comforting things in the world is finding out that other people suffer the same way that you do. Not because you are a masochist who enjoys other people's suffering but because you can console yourself with the fact that you are not a one-off freak who is experiencing something weird that your doctor has misdiagnosed.

One of the best ways to meet fellow sufferers, especially if you have agoraphobia or social phobia, is through an on-line forum. The problem is (and I used to be guilty of this myself) many people visit the forums and read the existing threads without contributing themselves. As well as being a little bit selfish, this has an effect on the forums because the less people who contribute, the less new members feel comfortable contributing, and the less sponsors are likely to fund the forums.

For many people, joining a forum and getting actively involved is a very effective form of therapy, and it gives everyone an opportunity to share their knowledge and opinions for a common good.

If you do one thing today, join a forum and tell the world about your own experiences. Most of them are free to join and there are people in there who may have the answers to your questions about anxiety. Also, it gives you a satisfying feeling when you are able to help others - even if it's just by saying "yes, I feel like that too."

I am a member of the following forums and I look forward to reading your experiences there in the near future...

Going for a walk - 14/07/2007

Well folks, here it is, my film-making debut. I don't think I'll get any Oscar nominations but it gives you a good idea of what it's like for an agoraphobic to go for a walk...

Links - 12/07/2007

Some new links that I've added to the useful links page...

Advice on agoraphobia and panic attacks, Very informative anxiety site, Anxiety tips from Caremark, Tips for Driving anxiety

Disturbing thoughts - 09/07/2007

This is one aspect of anxiety that people find it particularly difficult to talk about for fear of sounding like a complete psychopath but it is much more common than you might think.

From my own experience I have had thoughts about hurting myself or people close to me. I have lay in bed at night scared stiff that I'm going to get up and murder my parents or something - a thought that absolutely disgusts me. I have gone through phases where I fear that I'm going to develop some kind of paranoid psychosis or schizophrenia and be unable to distinguish between right and wrong behaviour.

Of course I have never acted on these thoughts, and the fact that they disgust me so much suggests that they go against my moral values and that I never would, but that doesn't make them any less scary.

People tend to hang on to things that have significance in their minds and when you suffer from anxiety it is the things that scare you that you give significance to. It is no different from a situation where you can't stop thinking about a headache because you think it might be something much more serious.

Curiously, I have found that my own disturbing thoughts have increased at times when I have dabbled with self-hypnosis. I think this may be something to do with a fear of something or somebody else controlling your subconscious mind and not trusting that it will continue to serve you as it always has.

If there is one grain of comfort I suppose it's the fact that people who really are going mad don't realise it and it is usually other people that see it before they do.

Challenging Negative Thoughts (Cognitive Therapy method) - 07/07/20007

Very often when anxiety strikes the fear is so overwhelming that your thoughts are channelled in only one direction - towards a catastrophe - and it is very difficult to challenge the negative thoughts. Writing things down can help because it is easier to be objective and concentrate on proof rather than hunches. In the following example, I am going to use my own experiences of believing that I might have a heart attack when I am in the grips of anxiety. You might challenge it with the following questions...

What makes you think that anxiety will cause a heart attack?

I get strange feelings in my chest and feel faint.

You have had hundreds of panic attacks; why haven't you had a heart attack before now?

I don't know.

What is the mechanism that would allow anxiety to cause a heart attack?

It makes my heart beat faster and raises my blood pressure.

Do you know what causes heart attacks? Do you think anxiety is part of that mechanism?

Heart attacks are usually caused by the heart muscles not receiving enough oxygen because of a blockage in the Coronary Artery. It is more likely to happen when the heart is under pressure because the heart muscles need more oxygen but anxiety does not restrict the flow of blood to the heart so anxiety will only exacerbate an existing condition, not cause a heart condition.

Is there a more sensible explanation for what you feel?

Yes, the adrenalin in my blood is causing my heart to race and making my chest muscles tense. Anxiety is also causing my stomach to receive less blood and that sometimes leads to acid reflux into the oesophagus, which can feel like sensations in the chest.

What would you say to a friend if they were telling you this?

I'd say "It's only anxiety, you know it is. You've experienced this hundreds of times and each time you think you're going to die but you are still perfectly healthy."

My Story submitted by Noony - 06/07/2007

I wanted to write and tell you about how ill I feel every day with anxiety and depression. I spend nearly all my time feeling sick and aching so much and every day I notice something else about my body that feels not right. I am always thinking about cancer and I'm convinced I have it. I always feel tired and can't remember the last time I woke up feeling energetic. I know deep down that a lot of it is because of anxiety and depression but I still can't stop thinking that I am going to die from a horrible disease. I went to have my heart checked out because it always feels like it will fail when I have anxiety but they couldn't find anything wrong.

anxietyforum.net - under new ownership - 05/07/2007

Hi everybody

The anxiety forum anxietyforum.net is now under new ownership. Here is a statement from the new owner...

Hi, my name is Brad, and I am the new owner of AnxietyForum.net. I am a 32 year old male from Sydney Australia, and have been suffering from anxiety for most of my life. At around 25 years old, I began to have full blown panic attacks. I had no idea what was wrong with me. After many visits to Psychologists and GP's, I have finally got my anxiety under some kind of control. I am hoping that my experience with anxiety and social phobia will rub off on the forum, and give other anxiety sufferers some help and hope.

Feel free to join the forum and say hello http://www.anxietyforum.net

So much to do, so little time to do it... 04/07/2007

If you are anything like me, you will find that anxiety seriously affects your ability to cope when you know there are things you have to do. Try as you might to break things down into sensible chunks, there seems to be an urgency to get everything done now and, in trying to do everything, you end up doing next to nothing. I can go from feeling fine to being a nervous wreck if I find out there is responsibility on me to get something done.

Why is this? Is it that we are scared that we will forget what we need to do? Is it that with a regular feeling of dread or fear of death, we feel like we have to get everything done before something terrible happens?

The average person will eat around a thousand meals in a year. Can you imagine piling a thousand meals onto your table and thinking "right, I've got to eat all this now"? Of course not; it's just another example of anxiety diminishing your self-belief and telling you that if you don't do it all now, you'll miss something.

Think about this: very few wars are won on the battlefield. Training and preparation is the key to being successful which, in this case, means being organised.

If you have a busy day ahead of you, take ten minutes to write down the things you have to do and give them a priority score. That way you can't forget them and you can keep a track of your progress and take satisfaction from crossing them off when they are done.

Think about what needs to be done today and what can wait, if necessary, until another day.

If one particular task seems daunting, ask yourself if it can be broken down into smaller tasks and think about which tasks depend on each other. For example, the other day I fitted a new stereo and speakers in my car. The door speakers really needed to be fitted before I locked the doors for the night so I took that as a separate task and made sure I got that one finished before it got dark. The other bits weren't so urgent and it didn't matter if they rolled over to the next day.

Most importantly, don't take on too much. Anxiety sufferers by their nature are generally quite submissive people who will try to help others, and if keeping busy helps to distract you then all well and good, but you shouldn't forget that you need time for yourself too.

Documents added - 02/07/2007

The following links have been added to the anxiety related documents link library...

Anxiety advice from Lancashire NHS Trust

Coping With Anxiety

Cognitive Therapy v Medication for tackling depression

Overview of Anxiety Disorders

Incapacity Benefit - 01/07/2007

For any overseas visitors, Incapacity Benefit is a benefit paid by the UK government to people who can't work because of illness.

I was recently contacted by a friend and fellow anxiety sufferer who was having difficulty filling out her incapacity benefit form and it made me think about the whole process of claiming benefits and how daunting it is.

You spend 90% of your time either telling yourself - or being told - that anxiety is all in your mind and convincing yourself that you are not ill, then you get the incapacity benefit forms and you have to convince someone else that you are ill.

I know from my own experience that, unlike physical illnesses, you tend to wrestle with your conscience a bit and question whether you should really be receiving the payments. You might feel (or be made to feel) like you are trying to con someone or commit benefit fraud because there is no visible evidence of illness and, because anxiety levels can fluctuate on a day-to-day basis, it is difficult to quantify the extent of your illness.

I also know that it is a struggle, if you are agoraphobic, to convince them that you need a doctor to come out and see you rather than attend an appointment at a remote location. Why should this be the case? It is a basic human right, written into European law, for a person to live in dignity. I know for a fact that there would be a very high risk of my dignity being compromised if I was asked to attend a medical examination in a town centre or similar busy place. It's hard enough visiting my own doctor's surgery.

It is also a time when having the support of your doctor can speed things up a lot and I know how dismissive some doctors can be of anxiety related illness and how difficult it can be to get them to take you seriously.

The only advise I can give really is to be honest, explain your condition as fully as you can (don't worry if what you write on the form makes you sound pathetic) and don't allow yourself to be intimidated by people who make light of mental illness. You have more right to the government's money than a lot of people who receive it.

Hypnosis - 29/06/07

I know that a lot of people consider hypnosis to help them with their anxiety but do you actually know what it involves or how it works? If you are thinking about hypnosis, you may find the following information useful...

What is hypnosis?

Hypnosis is an altered state of awareness in which the mind becomes more open to suggestion. The word itself comes from the Greek 'hypnos' which means to sleep, although the subject never actually enters a state of true sleep. The practitioner will use patterns of instructions to guide the subject into a state of deep relaxation in which the Critical Factor of the conscious mind is bypassed, allowing the practitioner to directly instruct the subconscious mind.

The Critical Factor

The Critical Factor is the part of the conscious mind that upholds our values and beliefs. It controls which new information we accept as true, based on our existing beliefs, and either distorts or rejects anything that doesn't correspond. If you believe that female drivers are useless then your Critical Factor is the part of your mind that makes you notice every time a female cuts you up, but not notice when a male driver does it. This way, it is always strengthening itself by only allowing in thoughts that reinforce it.

The subconscious mind has no power to reason and will accept pretty much anything that reaches it as fact, so it relies on the Critical factor to filter out thoughts that contradict our values. Therefore, if you suffer from arachnophobia, it is the filtering process of the Critical Factor that keeps you afraid of spiders. No matter how many people tell you that they are harmless, this will just be rejected by the Critical Factor because it doesn't correspond with your existing beliefs.

Myths about Hypnosis

Hypnosis is not mind control. You will not be under the control of the practitioner or anyone else and you will not do anything that you wouldn't find acceptable in everyday life. Also, you will not reveal anything that you would want to be kept secret.

Hypnosis is not sleep. The depth of trance can vary but many people find it comparable to daydreaming.

You can't get stuck in hypnosis. Even if the hypnotist disappeared while you were in deep trance, you would go to sleep and wake up naturally.

The Process

The practitioner will usually use some kind of progressive physical relaxation in which he will focus your senses and occupy your conscious mind with verbal instructions and suggestions. There are rapid methods of inducing hypnosis but these are more usually used in stage-shows than in therapy. The script may go something like this...

I want you to lie back and make yourself as comfortable as possible; lose any surface tension in your muscles and just relax. Get used to listening to my voice and my voice only. Notice any other sounds in the room and notice that you can safely ignore them as you listen only to me.

Pick a spot on the wall or ceiling and fix your eyes on it. As you listen to my voice and concentrate on the spot, you will notice your breathing slowing down and you may find it hard to keep your eyes open because your eyelids are growing heavier and heavier.

Start to relax all the little muscles around your eyes and concentrate on your breathing as the relaxation spreads down your face, into your cheeks and mouth...

Once the required level of trance has been reached, the practitioner will follow it up with post-hypnotic suggestions...

Your old patterns of behaviour have served you well but now it is time to learn something new. You are no longer afraid of spiders and you realise that the feeling of safety you felt from running away can be achieved while the spider is there...

Eventually the practitioner will bring you out of the trance but before they do, they may add suggestions to make future hypnosis easier... "you will find it easier in the future to achieve this level of relaxation". The awakening process will go something like this...

In a moment I am going to count to 5. As I do so you will feel your awareness coming back as you rejoin me in the room. You will feel fully alert and refreshed and you will not remember anything about this discussion...

Some practitioners will add that last sentence in an attempt to stop you from thinking consciously about the post-hypnotic suggestions and giving the Critical Factor a chance to reject them.

A Word of Warning

Hypnosis is considered to be perfectly safe but don't expect every practitioner to be like Derren Brown or Paul Mckenna. In the same way that some mechanics work in a back-street garage and some work in the Ferrari racing pit-crew, some hypnotists will be better than others and, like every therapy, for it to be successful you have to have a degree of belief that it will work.

Letter from Stephen - 27/06/07

I have suffered with anxiety for as long as I can remember and I hate the way it makes me feel so ill.

Some of the worst days were days when I didn’t feel particularly anxious or even depressed but I still felt ill – and these are the days when you really struggle to understand it. Sometimes I couldn’t bear the thought of getting out of bed and sometimes I felt like I had something bad hanging over me all day. My hands would be shaking, I would feel like I had no strength at all, that I was half-asleep all day and that I couldn’t concentrate on anything.

It sounds odd to say that you don’t mind having the physical symptoms when you feel anxious but at least you can console yourself with the thought that they are part of the anxiety. What do you blame them on when the anxiety isn’t present?

Is it because we’ve got into the habit of feeling ill and this carries on even when the anxiety abates?

What are the chances of that? 26/06/07

As you will all agree, the first thing to go out of the window when faced with an anxious situation is your ability to think rationally and logically. Part of that logic that you lose sight of is the ability to accurately assess the chances (odds) of something bad actually happening. Things that are, in actual fact, unlikely or near-impossible suddenly become probable or even inevitable in your mind. Of course, the odds of your fear becoming a reality haven't changed at all, just your ability to see the likelihood.

The odds against pulling an ace from a shuffled pack of playing cards is 1 in 13 (4 out of 52). The odds of pulling a second ace are then 1 in 17 (3 out of 51). Pulling a third ace then becomes a 1 in 25 chance (2 out of 50) and the odds of pulling the fourth ace becomes 1 in 49. Therefore, the odds of pulling out four aces in a row are 1 in 270725 (13 x 17 x 25 x 49).

Obviously, when there is an element of danger involved, the odds become less significant. Imagine the following scenario...

If you were standing in a bank when a gunman burst in you could try to ease your fear with the following thoughts:
• The chances of the gun being loaded might be 50:50 or 1 in 2
• The chances of him shooting someone might be 50:50 or 1 in 2
• There are twenty people in the bank so the chances of that someone being me are 1 in 20
• 70% of people that are shot don’t die so, even if I am shot, the chances of dying from my wounds are roughly 1 in 3 (this is a figure I have plucked out of the air)
• Therefore, the chances of me being shot and killed are approximately 1 in 240 (2 x 2 x 20 x 3)
Would that thought calm you down? No, of course it wouldn’t because the possibility of being shot and killed is so awful that, no matter how tall the odds, it is going to terrify you.

The biggest problem with anxiety and phobias is that you don't know the odds of your worst case scenario happening. What are the chances of having a heart attack? What are the chances of seeing a spider? What are the chances of the world ending?

A diagrammatical representation of the anxiety cycle - 23/06/2007

anxiety diagram

Trigger
In my own experience, anxiety can be triggered by anything from a door slamming to a television programme about hospitals to an unfamiliar physical sensation in your leg, but whether it is a sensory experience (sight, sound, smell, taste or sensation) or a spontaneous idea, it is invariably your perception of the trigger that initiates the anxiety. These perceptions are created internally from our own experiences and expectations and each of us will have a different perception of any given event.
Example 1
Mary is sitting in the house at night and she hears the front-door open. Her husband is working away and she has been sitting in the dark watching a horror film. She is terrified by the noise because she isn’t expecting it and she instantly interprets it as something very bad.
Example 2
Mary is sitting in the house at night and she hears the front-door open. Her husband went out five minutes ago to get some milk from the shops and she naturally assumes that it is him returning and therefore, a good thing.

In both of the above examples, the physical event (the door opening) and Mary’s sensory experience of the event (hearing the door open) are exactly the same, but the contexts of the experiences in her mind – i.e. her perceptions – are poles apart. The same is true of everything that you experience, be it sensory or imagined, the only meaning it can possibly have is the meaning that you give to it.

This can be illustrated on a much more fundamental level if you imagine there was somebody out in the street shouting. You might look through the curtains to see what the commotion was but generally speaking you’d ignore it – unless it was your name they were shouting. This would create a completely different meaning to the situation in your mind and your thoughts, emotions and actions would be driven by your new perception.

Now, just because it is you that is creating the perception, that doesn’t mean you are doing it consciously – and more importantly – just because you are doing it unconsciously, that doesn’t mean you can’t stop it. It is generally accepted in the field of psychology that we are born with two fears: a fear of falling and a fear of loud noises. Everything else you fear is only a fear because you have learned to fear it by assigning a meaning to it and, while it may be difficult or even impossible to unlearn it, it is possible to learn to assign a different meaning.

I have experienced hundreds of panic attacks and on a lot of occasions I don’t even know what the trigger is, let alone what perceptions I have formed. It may be that the process happens so quickly that your conscious mind doesn’t notice it; it may be that the original trigger gets lost in the avalanche of thoughts that follows – who knows? The important thing is that it takes practice to form more pleasant perceptions. When somebody asks you your name you don’t have to think about it because you have practiced it all your life. That doesn’t mean that no mental process takes place; it simply means that you didn’t have to subject your conscious mind to the process of retrieving your name. The same can be achieved with the subconscious process of forming perceptions.

Can I Dismiss?
The question of whether you can dismiss a negative thought before it develops into anxiety or at any point during the anxiety cycle depends on a number of factors. First of all there is the level of importance that we attach to an experience when we form a perception, or in other words, the perceived effect that it will have on our lives. Again, this will differ from person to person based on our previous experiences. If you were bitten by a dog as a child, you are much more likely to consciously notice the sound of a dog barking than you are to notice the sound of a bird singing because you have learned to attach a much higher degree of significance to the former. Conversely, if you are a keen birdwatcher, you are more likely to notice the bird singing as subconsciously that is more important to you.

Your state-of-mind at any given time will also affect your ability to dismiss negative thoughts and the level of significance you give to the perception. This will be determined by several factors such as:
• Physical tiredness
• Illness
• Hunger
• Mood
• Preoccupation
• Self-image
• Self-confidence
• Surroundings
You may wake up one morning with a headache and think nothing of it, whereas on a different morning, in a different frame of mind, you might be convinced that you have a brain tumour.

The above factors will affect your initial reaction to your perception, and even the formation of the perception itself, but there are also factors that will come into play as we start to ask ourselves questions about the negative thought during the anxiety cycle. See the Questions section below.

Have I Reached My Limit?
Everybody has a limit beyond which anxiety will not escalate. It may not feel like it when you are in the grips of a panic attack but, if left unchecked, the mind will eventually start to decrease anxiety on its own. I don’t know if this is because it cannot adequately concentrate on the anxiety anymore, or because the brain grows tired of it, or because the body’s parasympathetic responses cause chemical changes to suppress it – whatever the reason, be assured that it does happen.

Questions
The perpetuation of anxiety is largely governed by the questions that we ask of ourselves about that anxiety and the (often irrational) answers that we provide to those questions.

Asking questions is natural when you’re not sure what’s happening and it is a very good way to train the mind but the questions we ask about anxiety very often bring answers that lead to more questions and greater anxiety. This is not always the case; sometimes we will ask a question – and provide an answer – that does satisfy our need to know and reassure us about our negative thoughts. When this occurs the satisfactory answer will affect the ‘Can I Dismiss’ question.

The problem with the questions we ask is that they are vague and open to subjective rather than objective interpretation. For example, one of the first questions we ask on experiencing a physical sensation may be, “what’s wrong with me?” Now there’s no way we can be absolutely sure of the condition of our whole bodies so we rely on what little evidence we have and a lot of imagination to answer the question – and when left to the imagination, a question like “what’ wrong with me?” can conjure up an unlimited number of possible answers, many of which will be completely irrational and add to the anxiety.

For each response we give ourselves to the question we will then ask a set of qualifying questions:
What is the likelihood of that?
What could that lead to?
What does this mean for the future?
How could this affect me?
What is the worst case scenario?

Spaced out - 22/06/2007

One of the most worrying and annoying aspects of anxiety is the feeling of detachment that accompanies it. There are various theories about why this happens; some people put it down to a change in the amount of oxygen reaching the brain tissue and other people believe that the brain has some kind of desensitising mechanism that kicks in at times of trauma.

Even now when most of my time is relatively anxiety-free, I still seem to spend a lot of my time in a sort of spaced-out state, feeling like I'm not fully awake or not part of the real world. This is especially worrying when it comes to doing something that could be potentially dangerous, such as driving - although in the 8 years since I had my first panic attack, I have never come close to having an accident. You could argue that feeling this way makes you a much more careful driver.

I know from experience that anti-depressants can add to these unreal feelings and a lot of people won't take them because they end up "feeling like a zombie".

You can read an interesting article on this subject from anxietycare.org here.

It's the end of the world as we know it... 20/06/2007

Do you find that you suffer from panic attacks or that your anxiety worsens when there is a thunderstorm or really heavy rain? There is a specific fear of thunder (brontophobia) but I don't think this is quite the same. It's almost like you have an apocalyptic fear of bad weather - like the world is going to end.

I find that I get similar feelings when I think about volcanoes or earthquakes or nuclear war - even thinking about space. I get freaked out by aeroplanes flying over and any unexpected low-frequency noise - especially if I can't instantly identify where it's coming from.

If you have any similar experiences, email me your story and I'll post it on the site.

"I'm going to collapse" - 18/06/2007

Fear of fainting is a very common symptom of anxiety disorders and stems from the psychosomatic effects of panic such as light-headedness and disorientation/confusion. The good news is it is extremely rare to faint during a panic attack, here’s why… The human body has a number of built-in safety mechanisms to protect it from physical harm and fainting is one of these. The brain needs a certain amount of blood to circulate to it in order to get the oxygen it needs to function. If the amount of oxygen going to the brain drops below a certain level, the body will automatically attempt to remove one of the forces that may be restricting the flow of blood to the head – namely gravity – in the hope that losing consciousness will cause the body to assume a more horizontal position, removing gravity as an obstacle to blood-flow.

This would result if you were able to hold your breath for long enough or had a heart problem that resulted in low blood-oxygen levels, but a much more common cause is low blood pressure (hypotension). Hypotension can be caused by loss of blood or by dehydration or it can be a side-effect of certain drugs, it can also be caused by standing still for a long time or a sudden shift in the position of your body such as standing up quickly from a sitting position; this is called postural hypotension and usually results in nothing more than a temporary spell of dizziness.

Why is this good news for anxiety sufferers? Because during episodes of panic your blood pressure is higher than normal rather than lower and the increased heart-beat and heavier breathing are ensuring that more than enough blood is going to the brain. This is an evolutionary response to a fearful situation in which you might be required to fight, or run, for your life. At such times it is vital that you are alert and your senses are functioning as well as they can, so it is important that the brain gets more oxygen. This isn’t something we’ve learnt, it is the way we’re designed; it could, after all, be catastrophic for us to pass out at times of danger and so we are built to ensure this doesn’t happen.

This article first appeared on the Small Steps anxiety forum in September 2006. Click here to view the original article and its responses.

D is for... - 17/06/2007

Not a serious subject today, just an observation... Have you noticed, since the onset of your anxiety, how prominent the letter D is in your life?

You Develop Discomfort and Dread. You fear Death, Disaster Danger and Destruction (maybe even Dentists). You might be obsessive about Dirt or Disease. You become Depressed, Down and Desperate so you go to the Doctor who Diagnoses your Disorder. Your Depression Deepens on Days that are Dark, Dreary, Damp, Dismal, Dingy and Dull, and you might even Depend on Drink or Drugs. Then there's the Debilitating Drowsiness, Detachment, Depersonalisation, Derealisation, Desensitisation, Dizziness and even Delirium.

Like I said, just an observation. Don't Dwell on this Discussion.

Good Times, Bad Times - 16/06/2007

Have you ever wondered why one day you are completely terrified by a certain thought or object and the next day you can handle it?

This is not a phenomena that is unique to people with anxiety problems. The average man in the street might watch Bambi one day and bawl his eyes out, whereas on another day it might not affect him emotionally at all.

We all have millions of thoughts and they can combine with millions of other thoughts and sensory experiences to produce an infinite number of situations in our minds. Is it this transience of the mind that makes us more open to suggestion from one day to the next? Do we create more or less fertile breeding grounds for negative thoughts; and if so, do we do it unwittingly?

Is it a more physical thing? We are all just lumps of chemicals at the end of the day and the balance of chemicals on any given day must affect the conductivity of neural impulses in the brain. We know that anti-depressant medication works by changing the level of chemicals like serotonin and that physical exercise produces endorphins that affect our mood and motivation.

Whatever it is, it would be a lot easier to plan around our anxiety if we knew how brave we were going to be from one day to the next.

Trust yourself - 15/06/2007

A big problem faced by anxiety sufferers is that, over time, their (our) self belief becomes damaged and insecurity sets in and you start to doubt your abilities and distrust yourself. When this happens, you may start to find that you feel the need to 'think' about everything you do - whether it's climbing the stairs or making a cup of tea, you may find yourself analysing everything you do.

What happens in these situations is that you no longer trust your subconscious mind's ability to guide you through the simple things in life. Things that your subconscious mind has handled for years - with very little intervention from your conscious thoughts - suddenly become the hardest tasks because you start thinking about them. This can, and often does, include the most basic of biological functions too; we no longer trust that our breathing will continue on its own or that our heart is going to keep beating properly.

There's a similar phenomena in the world of sport: they call it 'the yips'. When a footballer only has to put his foot on the ball in front of an open goal to score but instead he thinks about where to place it and ends up missing, or when a golfer lines up a 2-foot putt that he would knock in 999 times out of a thousand but the thousandth time he thinks about it a split second before contact and misses.

When you introduce conscious thought into a process that is normally subconscious, you are introducing judgement, analysis and scrutiny - and most importantly, scope for error.

It is no different from when you are doing a pub-quiz and you answer a question with the correct answer from the back of your mind somewhere and then you start to think about it more and end up questioning yourself and maybe even changing it to a wrong answer.

I always liken it to a horse and a rider. The subconscious is the horse - powerful and fast but useless at making decisions or rationalising anything - and the conscious is the rider - smart, good at planning, but not nearly as powerful as the horse. The rider is good at planning the journey and deciding on the reasons for making the journey but that doesn't mean he has to get off the horse and show it where to put each foot when it takes a stride.

Trust your intuition - stop carrying your horse around...

Sex and Anxiety - 14/06/2007

Even in this age of streaming pornography and 24-hour uninhibited reality television, it is still a subject that makes schoolboys snigger and old ladies spit out their Pimms. But for people with anxiety issues it can be a real problem. I think, because of this, it is an appropriate subject to tackle - so, in the much repeated words of Salt n Pepa, let's talk about sex...

There may be people reading this who can attribute their anxiety problems to an incidence of sexual abuse and, while I offer you my heartfelt sympathy, I am not going to discuss this because I am neither experienced or qualified to address that subject with the sensitivity it requires.

The first problem, if you have agoraphobia or social anxiety, can be finding someone to do it with. Unless there's some bizarre twist of fate (or the postman's up for it) you aren't going to meet someone if you are restricted to your own house and garden. Many agoraphobics resign themselves to the fact that they aren't going to meet anyone and that's not such a bad thing, as long as you combine it with an attitude that says "ok, for the moment I'm not going to meet anyone so while I have nobody else to consider, I'M GOING TO CONCENTRATE MY EFFORTS ON ME AND GETTING ME BETTER." On the flip-side, we have a biological urge to reproduce and being unable to do so can very easily cause further distress and/or depression.

If you are lucky enough (or brave enough) to go out and meet somebody, you still have the daunting task of explaining to them that you suffer from anxiety and sometimes you might act in a way that they would not consider to be normal. And then there's the actual act of "doing it" for the first time... Taking your clothes off in front of someone else can be scary for anyone but if you are overly conscious about your body or worried that your heart is going to fail mid-romp, it can be even more terrifying.

On a serious note, many existing relationships come under considerable strain when one partner develops anxiety issues and if your attitude towards sex changes, that can just make things worse. Many people find that when they start suffering from depression or anxiety, sex becomes less of a priority for them and it's difficult to make your partner understand this without them feeling like you are no longer attracted to them.

Anti-depressant medication can - and very often does - affect your sex drive and your physical ability to become aroused and, when you already have very little self-esteem, the last thing you want is to feel less of a man or less of a woman because you can't function sexually.

If your anxiety is based on your health then any exercise that increases your heart-rate can make you feel like you are going to have a heart-attack or succumb to some terrible illness, and sex is no different - and it can't be very flattering for your partner to see a look of dread on your face at a time when you are supposed to be in the throes of ecstasy.

In summary, sex is good for you both physically and emotionally and if you are lucky enough to have a partner to do it with, or brave enough to go out and find one, try to enjoy it for what it is. You can always calm yourself with the thought "at least if I die, I'm going to die happy." For the rest of you (us) who are still single, maybe you could try my favourite agoraphobic's chat-up line - "my place or mine?"

Sleep - 13/06/07
A regular pattern of sleep is important for everyone but when you are prone to anxiety, anything that affects you physically (tiredness, hunger, illness) can have a profound effect on your anxiety level and your ability to cope with everyday life.

If there's one thing worse than lying in bed unable to sleep it is lying in bed unable to sleep because you fear for your life. Many anxiety sufferers have an abject fear of situations that they are not in control of and sleep, by its nature, is one of these situations. I know what it's like from my own experience to fully believe that if you go to sleep you will never wake up and to rely on exhaustion to get you to sleep. It is a time when you really have to put all your faith in your unconscious mind's ability to look after you - something we're not very comfortable with.

The problem is, even if you are not sleeping at night, the chances are you are still lying in bed, and if you then have to catch up on your sleep during the daytime, you start to spend a large proportion of your life lying down and completely inactive. This, coupled with the effects of adrenalin on your muscles, can lead to all sorts of aches and pains and many people with sleeping problems will experience aching arms, legs, chest, ribs, etc. These aches and pains can then easily be misinterpreted as more serious health problems and add to your worries.

Night times can be frightening enough anyway because it's dark and quiet and you naturally feel like any anxiety reaction you might have will be more noticeable to anyone trying to sleep in the next room or any neighbours that might see you from their window. The darkness makes you more prone to negative thoughts and suggestions (that's why people don't tend to watch horror films in the middle of a sunny day) and it is easy to feel completely alone.

So what can you do?

There's medication. Personally I have never taken sleeping pills so I can't comment one way or the other but I would be a lot happier if I was able to tackle the cause of the sleeplessness rather than the symptom. Here are some alternative tips for better sleeping:

Get into the habit of going to bed and getting up at the same time every day.

Make sure the room is well ventilated and not too hot. It is easier to get warm in a cold room than to get cold in a warm room.

Switch off any non-essential electrical equipment in your bedroom.

Don't drink alcohol or caffeine before you go to bed.

Don't go to bed hungry. Have a snack but avoid sugary foods.

Get some exercise in the daytime. Even if it's a gentle stroll around the block, do something that will get your muscles moving. Don't exercise within 2 hours of your normal bedtime.

Get your mind ready for sleep. Have a bedtime routine that you will come to associate with sleep. Dim the lights in the house in the hours before bedtime.

Use your bed for sleep. Don't lie around on it in the daytime watching television or reading.

Don't watch the clock or stress about what time it is.

Most importantly...

If you are not asleep within 30 minutes of getting into bed, get up. Don't just lie there getting more and more frustrated. Get up and do something. Do a crossword, rearrange your sock drawer, delete all the old text messages from your mobile phone - something that is not stimulating.

...sweet dreams.

Update 11/06/2007 - We still want to hear from people who suffer from anxiety, panic attacks, phobias, agoraphobia, etc. Please mail us your story here .

5 tips for getting rid of a panic attack:
Distraction    This can be difficult because you feel that it is critical to think about the panic but if you can get your mind on something else, you can't devote so much of your mental capacity to panicking. Find someone you know and talk to them about something that is not related to anxiety. Ask them how their day has been.
Breathing    Panic attacks cause the breathing to become quick and shallow and this increases your sense of urgency. Breathe right down into your stomach so that you can feel your stomach expanding and slow your breathing down to a count of 7 as you inhale and 11 as you exhale.
Interruption    Over time you develop habits for coping with your panic. It might be that you rush home or you find a quiet place. Unfortunately, you come to associate completing the habit with safety so you feel that until you have completed the habit, you are not safe. Interrupt the habit. If you are out walking and feel the need to rush home, do something out of the ordinary. Stop and take a few steps backwards before you continue.
Rationalisation    Remember FEAR is not DANGER. Think about all the times in the past you have experienced this and survived unscathed. Fear can't hurt you.
Talk To Yourself    A good way to rationalise your thoughts is to put them into words and think about how it sounds. "I am approaching the end of the street and I am very scared because I feel like I'm going to collapse or die." Think about how you would feel if it was someone beside you saying this and what you would say to them.

More tips
More tips
More tips

Update 10/06/2007 - Do you feel like your throat is closing up or that you have something stuck in it when you experience anxiety? Does it cause problems with swallowing, talking, or even breathing?

We know that anxiety causes a release of adrenalin and that adrenalin causes your blood flow to divert so that the bigger muscles in your limbs get more blood and your internal organs get less. We know that this can lead to indigestion, belching, dry mouth, etc. We also know that acid reflux can be behind the feeling of an obstructed throat.

Could it be possible that the oesophageal sphincter is weakened by this lack of blood allowing the stomach's acid to rise in the throat and causing a temporary gastro-oesophageal reflux?