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How not to worry: A guide to reducing everyday anxiety

Britain is an anxious nation – and the credit crunch will only make things worse. How can we stop fear taking over our lives? Simon Usborne seeks advice from the experts

Tuesday 16 September 2008 00:00 BST

House values are still dropping, unemployment is on the rise, our holi-days suddenly look vulnerable, and our credit has been well and truly crunched. These are anxious times and, as the reasons to worry multiply, there are signs that therapists could join insolvency lawyers, campsite owners and budget-supermarket bosses on the shortlist of winners in the economic downturn.

Last week, psychologists in Spain, which is on the brink of recession, released figures showing that more people are turning to counsellors to help them cope with money worries. In the UK, NHS figures for 2007 suggest that one in 50 of us are affected by Generalised Anxiety Disorder (GAD), or persistent and irrational worry about everyday things, while at least one in 10 of us suffers the occasional panic attack. As the nights draw in on the summer that never was, it is perhaps only a matter of time before these figures start climbing, but there are things that we can all do to keep anxiety at bay.

Know the enemy

Anxiety is "an enhanced state of psychological arousal", explains Trevor Turner, a consultant psychiatrist in east London, and the author of Anxiety: Your Questions Answered. "It's a perfectly natural safety mechanism designed to deal with potential threats or threatening situations." There was a time when these threats came in the form of predators, or competition for food. These days, it's more likely to be exams, tough times at work or financial worries. "The modern world is highly anxiety-inducing," says Turner. "And we react the same way, with a fight or flight response – our brains go in to alert mode."

The effects are not only psychological. "The first thing people who suffer from anxiety notice is often alarming physical symptoms," says Caroline Carr, a hypnotherapist and the author of How Not to Worry, out this month. "There can be palpitations, an increased heart rate, nervous sweats, muscle tension, tummy churning, or a shortness of breath. I knew someone who had a very tense jaw in the morning. He could barely open his mouth but couldn't understand why. It turned out to be anxiety.

"These symptoms should subside when the perceived threat is over," adds Carr, "but because we're dealing with modern 'emergencies' on a daily basis, people can put themselves under such persistent pressure that the chemicals the body produces to combat the threat have no outlet other than to cause the symptoms of anxiety."

Pound the pavement

"Any exercise is good for combating anxiety," says Turner. "And regular exercise helps your body to get tired, so you sleep better. A regular sleep pattern means less worry. Exercise also gets rid of some of the chemicals, such as adrenalin, that contribute to anxiety." Aerobic exercise such as running, or even fast walking, as well as cycling and swimming, also strengthens the heart, making it less prone to the kind of pounding that make the physical symptoms of anxiety so distressing.

But Carr warns against doing too much. "A lot of people like strong, hard exercise, and to push themselves. They wear pedometers and heart- rate monitors, and that's fine, but there's so much pressure to do a lot of exercise that I think the key is to avoid beating yourself up. If you don't feel like putting in that extra mile, or going to the gym tomorrow morning, then don't – it's not the end of the world."

Take it easy

For many of us, being told to relax is as useless as being told not to worry. The trouble is, many of us don't know how. For many more, the pace of life means that it doesn't come naturally. But if the idea of lying on the sofa is anathema to you, there are techniques that turn relaxation into an activity. "I see yoga and meditation as self-induced relaxation, and they help," says Turner.

Carr agrees: "There are all sorts of therapies that help anxiety by suggest-ing relaxation. It works because it sends the message to the body that you don't need to get ready for an emergency. One of the most beneficial things to do is consciously to undertake a progressive relaxation of your body. Starting from the tips of your toes, tense and release each muscle in your body, working your way all the way to your head. You can do this lying down or sitting, and it can help to record yourself or a friend calling out the muscles – playing it back helps you to focus. If you can do that every day, it's fantastic, and when you get to grips with it you can do it anywhere – on the train or at your desk. I say a few minutes of that is as good as an hour's sleep."

Learn to breathe

It's easy to forget about something that comes so naturally, but breathing properly is one of the easiest ways to calm the nerves. "Hyperventilating can lead to a panic state in no time at all," says Turner. "Controlling anxiety by learning to breathe more deeply rather than with short, shallow breaths is not complicated."

Carr recommends combining breathing exercises with her relaxation techniques. "A lot of people sitting at a computer all day suddenly realise that they're not really breathing. Obviously they are, but it's often too quickly. Or perhaps there's a period when they unknowingly hold their breath.

"When you're in a relaxed state, practise deep breathing. Always breathe out first to get rid of the air in your lungs. Pull in your stomach to help force it all out. And then, in your own time, allow yourself a good deep breath in."

Turner says that breathing plays a key roll in panic attacks. "The best solution is one of the simplest," he says. "Breathe into a paper bag so that you inhale your own air. It keeps your carbon dioxide levels up to stop you feeling dizzy or light-headed."

You are what you eat

"The food we eat affects everything," says Carr. "And if we put rubbish in we can only expect a rubbish service." Turner says that it's important to avoid anything that is likely to stimulate the nervous system, enhancing the fight or flight response to stressful situations. "Too much caffeine in coffee or tea, and chocolate will get you hyped up. And a high-sugar diet will affect your appetite. I know people with bad anxiety problems who say that half a cup of coffee brings them out in the sweats, so they don't touch the stuff.

"Alcohol is a good anxiety reliever," Turner adds. "For me, at least two glasses of first- class red wine a day is a very nice relaxant, but you have to be careful because you'll start needing more and more to maintain the release from anxiety, and end up drinking far more than you should."

Just say "no"

"I can't emphasise enough how important this is," says Carr. "People are under so much pressure right now, especially those working long hours, and giving their absolute best trying to meet virtually impossible targets. They have no work/life balance – it's all work, work, work, and they feel terrible because they're under so much pressure. Life is meant to be enjoyed, and often the simplest way to reduce anxiety is just to say 'no'."

Saying "no" doesn't only apply in the work place. "We tend to tell ourselves these little lies," says Turner. "It happens in social situations. Sometimes you should ask yourself, do I really like talking to these people because they're interesting or because I feel like I should? It's easy to feel overwhelmed by people, but life is about doing things you like, not forcing yourself to do things you don't want to."

Alternative therapy

Those seeking alternative therapies are spoilt for choice like never before, and while many question the science behind some of the more obscure treatments on the market, they can all prove beneficial in combating anxiety. "They operate on the same principle, whether it's aromatherapy, acupuncture or crystal therapy," Turner says. "They make you relaxed and there's the potential for talking, both of which help, however you achieve them. The physical therapies, such as Pilates, massage and yoga, are all very good because they also relax your body – and muscle tension is a key component of anxiety. They're all harmless, and most people come out feeling better than when they went in."

Carr suggests another alternative therapy: "Just enjoy life, for goodness sake. That's what it's meant for. Be sure to make as many opportunities to laugh as possible. If you don't, anxiety is more likely to strike and that can make people avoid social situations – it's a vicious cycle."

Get some help

If all else fails and the symptoms of anxiety persist, it's time to see your GP. "It's especially important to see a doctor if you think you're getting panic attacks," says Turner. "These are discrete episodes that often happen in crowded places. Your heart starts pumping, you can't get your breath, you feel like fainting and your legs turn to jelly. Some people feel as if the ground is moving or are convinced something awful is going to happen – a terrifying sense of doom.

"Your GP should then refer you to a psychologist who will teach you anxiety-management techniques and offer cognitive behavioural therapy (CBT). Some will prescribe drugs. All GPs should have access to local psychological therapy partners, and many will have them in-house."

"A little anxiety is important – it helps us to focus," Carr says. "It's perfectly natural, but it shouldn't be too much. For many, it is hard to bear, and they think things are never going to get better, but if you manage to understand and accept the anxiety and the causes, things do get better."

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