Overcoming Anxieties

Continuing the conversation from iPain Living Magazine Spring 2021 edition by Christina Chororos.

Check out the Overcoming Anxiety by Christina H. Chororos in Spring 2021 iPain Living Magazine www.ipainliving.org

With all of that said in my current article in iPain Living Magazine (Spring 2021), here are three of my favorite healthy coping strategies for overcoming anxieties and feelings of hopelessness, helplessness, and fear in 2021:

Incorporate meditative breathing into your everyday life. 

When most of us hear the word meditation, we cringe. The idea of sitting quietly with our thoughts is downright frightening. After all, it seems counterproductive—if we are already struggling with our thoughts, why would we want to focus more on them?! Well, because meditation has been shown to help our mental and physical health significantly.

Several studies have been conducted to prove that mindfulness significantly helps with mental and physical illnesses. Mindful.org describes mindfulness as “the basic human ability to be fully present, aware of where we are, and what we are doing, and not overly reactive or overwhelmed by what’s going on around us.” In fact, the number of randomized controlled trials — the gold standard for clinical study — involving mindfulness has jumped from one in the period from 1995‒1997 to 11 from 2004‒2006 to a whopping 216 from 2013‒2015, according to a recent article summarizing scientific findings on the subject. (Powell, 2018)

What have the studies found? Mindfulness benefits against an array of physical and mental conditions, including irritable bowel syndrome, fibromyalgia, psoriasis, anxiety, depression, and post-traumatic stress disorder. (Powell, 2018)

Some of the studies have been questioned, to be fair, because they had small sample sizes or experimental design flaws. However, there are a handful of mental and physical health problems that include depression, chronic pain, and anxiety where well-designed and well-run studies have shown the benefits of patients engaging in mindful meditation; so much so that effects have been similar to other treatment protocols. (Powell, 2018)

The good news? We don’t need to be Buddhist monks to reap mindful meditation benefits. Breathwork, the foundation of mindfulness, effectively manages depression, anxiety, and even chronic pain.

Breathwork is defined as the conscious control of the rate, rhythm, and depth of breathing, a technique used in relaxation and meditative practices to reduce psychological stress, control anxiety, emotion, and focus thoughts. (Breathwork, 2009).

In ancient yogic teachings, the practice of directing the breath is called pranayama, and it teaches you to breathe consciously, with awareness, and with intent.

If you’re a novice, here are a few tips and tricks to get started: 

• Think of a newborn infant when breathing.

Have you ever really watched a newborn breathe? They take breaths with their entire bodies—their bellies and chest expand and rise when they’re breathing in, and as they breathe out, their chests fall, and their bellies collapse. That is the correct way to breathe.  

• Personal mantra: “I breathe in peace; I breathe out calm.”

As you breathe in, I’d like you to say to yourself, “I breathe in peace.” As you breathe out, I’d like you to say to yourself, “I breathe out calm.” Repeat this 10-15 times.

Not only will this occupy your mind by giving you something to focus on, but simply repeating the phrase to yourself will help you to feel peaceful and calm. If you do not like that phrase, you can change it to anything that you think will be soothing. 

• Try breath counting.

Breath counting works similarly to a personal mantra. As you breathe in, say to yourself, “breathe in one.” As you breathe out, say to yourself, “breathe out one.” Continue breathing—as you breathe in again, say to yourself, “breathe in two,” and as you breathe out again, say to yourself, “breathe out two.” Continue in this fashion until you get to four…and then start over again. 

• Use your Smartwatch.

I have owned both a Fitbit smartwatch and an Apple smartwatch. Both have a “breathing app” that is fantastic for beginners. There’s a graphic that you follow as you breathe in and breathe out. Both apps have the option to practice from anywhere from 1 minute to 5 minutes.  

Practice escapism (the healthy way). 

Escapism is a fancy word for distraction. Inherently, we lean on distraction when we are trying to occupy ourselves from persistent feelings of sadness, grief, anxiety, or upset.

Here is how it works: When an overwhelming emotion, thought, or feeling surfaces that spark anxiety, implementing healthy distractions like exercise, reading, meditating, journal writing, or listening to music can help. In other words, things that contribute to and support your mental and physical health.

Why do we want to do this? Typically, when an overwhelming negative or anxious thought arises, we tend to concentrate on the upset state we’re in– essentially amplifying the unmanageable emotion. Distraction breaks this cycle redirects you and provides a metaphorical time-out. In turn, this allows you to calm down and return to the feeling when you are in a better, healthier place.

We know that distraction has been shown to be a useful coping skill for mental health, but did you know that for those of us who suffer from chronic pain, distraction can also deliver pain-relieving effects? Seriously. A study published in Current Biology in May 2012 found that mental distractions actually inhibit the response to incoming pain signals at the earliest stage of central pain processing (Cell Press, 2012).

Interestingly, though distraction can be categorized as a positive, healthy coping strategy, it can also be considered a negative, unhealthy one. Let me explain.

Distractions, like playing video games, scrolling through social media, or watching television, can often be taken to an extreme, making them potentially problematic. Often, distractions like these can consume us, eventually becoming an addiction. Remember, we want to use escapism as a form of temporary relief—we don’t want to use it to run away from our problems entirely.

As a means of juxtaposition, unhealthy distractions include drinking alcohol, using illicit drugs, and gambling.

Understand the biology behind a panic attack

My clients tell me that this is perhaps one of the most effective tools I share to tackle anxiety and panic attacks.

Panic attacks can make us feel as though we’re dying. We can’t breathe, our hearts are pounding, we’re sweating and shaking—we feel like we are in grave danger, but I’m going to share a secret with you—you’re not. It’s quite the opposite. Your body and mind are trying to protect you! Really! Allow me to explain.

We all have an autonomic system—an automatic system in our bodies that control things like temperature, heart rate, breathing rate—things we do automatically and without thought. That system contains the fight-or-flight system. When we are in a real or perceived danger, this system tells us to fight or flee.

When we begin to experience anxiety or panic, our brains are telling our bodies, “uh oh, we’re in danger!” A hormone is then released called adrenaline. The body floods our systems with adrenaline to protect us—to help us get us away from a real or perceived danger.

Once adrenaline is released, some of the following systems are mobilized all at once. It is important to note that these are in no particular order.

Our eyesight will begin to change to focus on a potential threat. Our pupils will expand to…get this…track fast-moving objects. Our attention narrows to focus on potential danger. If there isn’t a real danger, we can feel tunnel-vision.

Our circulatory system will kick into gear and quickly move blood away from our core to our extremities…so we can run away faster. While blood is being moved away from our core to our extremities, our hearts are pumping more quickly, which will cause us to feel our heart pounding.

Meanwhile, our endocrine system starts secreting endorphins—the feel-good hormones—something like dopamine. The reason for this? Our bodies want to dull the perception of pain in anticipation of an injury. Pretty impressive, right?

Then our digestive system comes into play. As blood is being diverted from our core organs to our extremities, digestion slows —which causes nausea or that feeling in the pit of your stomach.

Panic induces sweating but what’s interesting is that the body quickly works to cool itself so it can prepare itself for exertion if we need to run away or fight. So, some of us will feel a wave of heat wash over us, while others might feel that cooling sensation.

Lastly, our respiratory system is engaged, and the tubes that connect our lungs to our windpipes dilate to take in more oxygen. That can lead to rapid, shallow breathing, leading to hyperventilating or feeling as though we are being suffocated or smothered (Goecker, 2019).

Eventually, our bodies and minds realize that we’re not in any real danger, and these systems will start to pull back—hormones like adrenaline and cortisol will begin to get reabsorbed into our bodies—but that can take up to an hour. So, it’s incredibly normal to feel exhausted after a panic attack because our bodies were ready to either fight for our lives or run for our lives.

The biggest misconception that we have about panic attacks is that we feel like we’re in grave danger, when in fact, our bodies and minds are simply acting out of instinct and biology to protect us from grave danger.

The more that you incorporate these techniques into your daily lives, the better off you will be. You want to be extremely familiar with these coping strategies so when the moment arises, you can quickly downshift to using one or two.

For additional tips and tricks for managing life with chronic pain, chronic illness, and mental health difficulties, please visit my company’s Instagram page at https://www.instagram.com/christinac_kcpc/.

Citations:

1. Xiong, J., Lipsitz, O., Nasri, F., Lui, L., Gill, H., Phan, L., Chen-Li, D., Iacobucci, M., Ho, R., Majeed, A., & McIntyre, R. S. (2020). Impact of COVID-19 pandemic on mental health in the general population: A systematic review. Journal of affective disorders, 277, 55–64. https://doi.org/10.1016/j.jad.2020.08.001
2. McIntyre R.S., Lee Projected increases in suicide in Canada as a consequence of COVID-19. Psychiatry Res. 2020;290 doi: 10.1016/j.psychres.2020.113104
3. Ruby, F. J., Smallwood, J., Engen, H., & Singer, T. (2013). How self-generated thought shapes mood–the relation between mind-wandering and mood depends on the socio-temporal content of thoughts. PloS one, 8(10), e77554. https://doi.org/10.1371/journal.pone.0077554
4. Powell, A. (2018, April 9). Harvard researchers study how mindfulness may change the brain in depressed patients. Harvard Gazette. https://news.harvard.edu/gazette/story/2018/04/harvard-researchers-study-how-mindfulness-may-change-the-brain-in-depressed-patients/
5. (n.d.) Medical Dictionary. (2009). Retrieved January 11, 2021 from https://medical-dictionary.thefreedictionary.com/Breathwork
6. Cell Press. (2012, May 17). Pain relief through distraction: It’s not all in your head. ScienceDaily. Retrieved January 12, 2021 from sciencedaily.com/releases/2012/05/120517132055.htm
7. Goecker, L. (2019, October 14). The Biology of Panic Is Much More Than an Adrenaline Rush. The Swaddle. https://theswaddle.com/biology-of-panic/