The tools I use to cope with anxiety
Anxiety is the one constant in life; when I’m not anxious I feel strange. I often feel like there’s something ineffable which I should be doing, even when, for all intents and purposes, there’s nothing to worry about. Consequently, since Monday 10th October was World Mental Health Day (and I’ve been known to struggle with executive function), I thought that I’d share the strategies which I use to help me cope. Fair warning, this won’t be suited to everyone. If you have any further suggestions to add then please leave a comment. As always I’d welcome your feedback.
A little background – what has made me anxious in the past?
Growing up, I always felt tired and confused, which I misconstrued as a symptom of puberty, rather than a result of sensory overload. School was a double-threat to me; I could just about pay attention in the classroom (when I was interested), but I found it really difficult to engage with my peers when not socialising about shared interests. Football, athletics, and music were all ok by me, but high-pitched excitement (e.g. putting on silly voices) and general horse-play were an assault to my senses. Consequently, in larger group settings I tended to observe rather than interact (or be anti-social, as some of my friends liked to point out). There were also times when I’d back out of social settings altogether, which led to fewer invites. For me, the first step to coping with anxiety was to recognise it in the first instance, which is something that only occurred to me in my mid-20s.
In the past I’ve had therapy (a combination of CBT alongside other acronyms I’ve forgotten) to try and mitigate my mental health difficulties, and there appears to be two schools of thought in relation to this: one which says that CBT can be adapted for autistic individuals; and the second, which I fall into, that find it unnecessarily confusing/unhelpful, and hence a source of anxiety. Finding a therapist who has sufficient knowledge about autism is still quite tough. The fact that I had 8 months of therapy without being identified as an Aspie/autistic serves to illustrate this point.
Attending therapy in of itself placed me into an anxious situation where I learned to understand that unexpected change – a huge cause of stress – was a given. One aspect of therapy which didn’t help this was the use of figurative language. My therapist gave me an article to read entitled: “The Don’t-Get-Eaten-Machine” (Ciarrochi & Bailey, 2008), which I found confusing. I ended up writing a commentary about the article in an attempt to comprehend what I had read. In preparation for this blog post I stumbled across a piece by Dr Kimberley Sogge, which has helped me to contextualise the “Don’t-Get-Eaten-Machine”, but I think if anything my experience serves to illustrate that when someone has a literal use of language (which is common in the autism community) it isn’t necessarily going to be useful for them. It’s scenarios like this which can be avoided if the therapist has an understanding of the difficulties we face. It’s for this reason that we at Aspie Trainers are actively trying to offer training to mental health professionals.
The thing which I found most annoying about therapy was the assumption that I was there because I was broken; that my presence at the assessment and treatment centre was tacit acceptance that my world-view was flawed, and consequently of less value, because it wasn’t considered “normal”. The reality is that I’ve had to adapt to fit into a society for which I wasn’t born; mental health professionals projecting their thoughts onto me won’t change that. At best, they might be able to offer autistic people strategies to use to help them mask our difficulties. The first stage of that process is to learn how we think, without judging it.
Moving forward – how have I learnt to cope with anxiety?
1 Accept that you will be anxious and recognise that it’s ok.
I believe it’s important to recognise that anxiety isn’t always a bad thing. Cortisol, also known as the stress hormone, is responsible for what happens to our body during stressful episodes, and it fluctuates daily; it’s possible to have too little, as well as too much (Wilson, 2009). Good stress, or eustress, can drive people onto achieve things (Stress-Relief-Tools.com, 2009), so that’s something worth considering too. For instance, I’m now driven by stress to deliver training sessions, which will hopefully be beneficial to all whom receive them.
When coping with anxiety, the first step for me was to accept that there will always be times and places where I’ll feel anxious. The second was to recognise situations which are likely to evoke such feelings. Examples include: unfamiliar locations; meeting people (not necessarily just for the first time); noisy environments; meeting deadlines; travelling (for work and holidays); unexpected situations; there’s too many to list. The good news is that whilst other people may experience anxiety differently, you’re not alone in feeling anxious. Consequently, there’s no reason to feel ashamed or embarrassed by it. To be anxious shows that you care about what might happen, after all.
2 Learn to identify which situations are likely to cause you to be anxious.
This process allows me to plan ahead, so that I can begin to formulate strategies that will help alleviate, if not eradicate, what hinders me. Please don’t misunderstand me; it’s not an excuse to avoid these situations. Before I go to bed each night, I like to think through what I need to do the following day and identify any difficulties that may arise. When I wake up I try to repeat that process in order to get me set for the day ahead. For example on Tuesdays I usually work in the office, which means that I have to catch a train. With the on-going rail problems this can sometimes mean a change in train timetable. I knew that there was a strike planned for last Tuesday, so the night before I checked the National Rail website to see how it would affect me. It turned out that my train would be slightly earlier, so I set my alarm half an hour earlier to ensure my routine wouldn’t be too affected. Seem simple? It definitely is, but I’ve found it effective.
3 Formulating strategies
Whenever I have something to do, particularly if it’s social, I often find that it’s useful to consider the following factors:
If I’m planning on attending a social gathering, then I have to take my energy (and blood glucose) levels into consideration. I don’t like travelling by road (i.e. bus or car), so if I have to travel, then I need to take into account how far I have to walk and ensure I leave myself enough time as a contingency for the unexpected (such as a change in weather, the trains running late, getting lost…). Additionally I have to ensure that I have glucose tablets with me, in case I should have a hypoglycaemic episode (in other words, when my blood glucose levels fall too low).
The Social Environment
Being in a familiar environment enables me to relax a little more. It’s also worth bearing in mind that it helps if I’ve had a positive experience in the place in question. Failing that, it’s usually preferable for me to be with someone I know when venturing somewhere on a social outing. I also try to see if I can view the place online prior to going, or failing that, ensure that I arrive early so that I can get a feel for it (most of the time I end up doing both).
Prior to my Asperger’s diagnosis, I had a negative experience in the West End of London. I was attending a friend’s birthday party on a Friday evening at nine o’clock (needless to say it was busy) and was due to meet with my friends at a members-only bar. It turned out that they were late (apparently it’s fashionable), meaning that for the best part of two hours I had to occupy myself until their arrival. This, coupled with the fact I was wearing a suit (which I find physically distressing), eschewed that I was on the beers that night in order to a) blend in with the bars’ constituents, and b) alleviate stress. The alcohol wreaked havoc with my blood glucose levels, which in turn caused more stress. I no longer drink, but that’s a separate issue…
Whilst I wouldn’t classify that night as one of the worst in my life, it is not something I’m likely to forget. Given that my past experiences have an impact on my future decisions, I’m less likely to be as adventurous again without remembering what happened that night. That’s not to say that I’ve stopped socialising with those friends, however.
The Number of People
Put simply, the greater the number of people, the less likely I am to want to socialise. Congregating in numbers exacerbates my communicative difficulties; due to sensory overload it also impairs upon my ability to focus. The graph below is a visual representation of the point I’m trying to make:
The idiom: two’s company, three’s a crowd applies here. As the number of people (including myself) increases above two, my anxiety levels increase, and hence my desire to socialise diminishes (as illustrated, I become socially disinclined when there’s more than two other people)… It’s quite simple really.
For as long as I can remember I’ve never felt comfortable in my skin. My main sensory issues include: avoiding eye contact/excess light whenever possible; avoiding physical contact; and avoiding obtrusive background noise (which doesn’t necessarily include music, so long as it’s bass-driven and well equalized). More often than not I can gauge situations that will present problems, for example built-up cosmopolitan arenas, stadiums, and bars. I’ve come to accept that there will be occasions when I have to endure some problems (for instance travelling by train), that I need to focus on just getting through the experience, and taking time to recuperate afterwards (which usually involves being alone and listening to music).
It’s imperative for me to prepare myself mentally for any social situation I’m going to attend (including work). This usually starts the night before (see above). This can take half an hour, but in some cases (for instance some sort of care appointment, or an impending training session), I can become obsessed with it for weeks. I find that it’s also important to ensure that I have time to recover afterwards, too. It usually takes me a day to recover from a relatively stress-free social engagement, although it can also take me weeks to process what’s gone on, before I can learn for the next occasion. Sleep is an important part of the recovery process. When possible, I take naps during the day, as well as aiming for 8 hours a night.
In a previous post, I wrote briefly of my struggle with communication. In order to combat this, it can be useful for me to prepare by answering the following questions prior to the event:
I find it useful to remember that sometimes people just aren’t interested in what you have to say (asking questions to see if they’re processing what you’ve said is a useful tip), some are completely egocentric (or just venting their frustrations), whilst others suffer from a condition I like to call verbal incontinence (these people either talk a load of crap, or use as many words as possible to convey their point).
4 Remember not to be too hard on yourself!
A bugbear of mine is that some people have labelled me as a perfectionist. I don’t believe in perfection, since I don’t consider that anything is, or truly can be, perfect. I’m incapable of stating what would encapsulate a perfect day for me, for example, because I struggle with abstract hypotheticals. It would depend on my mood, what I had been up to recently, the time of year, the weather… They’re too many variables for me to consider, so I try to keep my expectations realistic; I try to figure out what it is that I want to get from a situation, and then break that thing down into chunks, in order to make it easier to achieve.
In situations when things don’t go as I expected I try to be rational, look at both the positives and the negatives, and aspire to learn from what happened to ensure that any mistakes I (or others) have made can be avoided in the future. I try to listen to, and accept, criticism, remembering that it’s an opinion which could be based on another person’s thoughts and feelings, or perhaps just a simple misunderstanding.
In short, if I commit to something then I do it to the best of my ability at that point in time. Reflecting on things at the end of the day can be useful, but only if it helps me to move forward.
5 Exercise (don’t forget to eat and stay hydrated)
I’m one of those people who feels better when they’re active; doing something lessens my anxiety somewhat, and it also helps me to maintain cortisol, and hence blood glucose, levels. I prefer to exercise alone, and I’m fortunate that my father allows me to use the garage for gym space. Consequently I lift weights, followed by cardio, 3 times a week, and I try to avoid being sedentary for long periods. People at work may think I’m being kind by offering to make them a drink (which I am), but to be honest it’s a bonus for me to get up and walk around for a bit! In addition to this, I aim for 10,000 steps a day. I usually like to do this whilst listening to music. Walking allows my mind to wander, which can be a great stress-reliever.
Since I’m fairly active, I need to ensure that I eat regularly and drink plenty of water (four balanced meals and 3 litres of water a day, respectively). I also made the switch from caffeinated to decaffeinated coffee, which has been linked to higher stress levels (Lovallo, et al., 2006).
6 Reward yourself
It’s important to recognise when something has gone well; I don’t feel pride, but I do acknowledge when I achieve things as a step in the right direction. I tend to reward myself by listening to music, and, when the incumbent lord-of-the-sofa is absent (a.k.a. Dad), I like to play the piano (although not as well I should like). Consequently I like to download music on to my iPod (I’m Old Skool) and listen to it in the garage in (relative) peace and quiet. Ok, so I get a few odd looks from the neighbours, but that’s their problem. I believe that I’m able to find music which reflects my mood better than I am able to express myself verbally. When I’m really anxious, Chopin’s Prelude no. 16, Op. 28 is a great comparison:
If you feel that listening to this makes you anxious, then you should try reading the score (or worse still, playing it yourself).
Conversely, if I’m feeling reflective, then Liszt’s Un Sospiro usually does the job for me (again, extremely difficult to play):
Another more recent example would be this one by Way Out West:
Listening to music also helps when I’m struggling to sleep, too. If I wake up in the middle of the night and then can’t get back to sleep, then it’s off to the garage I go.
7 Reach out to others
This is something that I’ve been getting better at recently. In the past I used to keep things to myself; partly because I wasn’t sure how to express my feelings, but also because I didn’t want to be judged (I still don’t, for that matter). Fortunately I have a supportive family, so if I’m troubled by something particularly perplexing then I’m able to talk to either my Dad or my sisters about it. Keeping in touch with friends helps, too. I try to reciprocate when then they need to talk, not just because it’s the right thing to do, but because I find that by listening to their problems I’m able to put mine into context; perspective is everything.
Wow, that was a long post…
I hope you’ve found this post helpful, or that it at least allowed you some insight into how I live with anxiety. Right, it’s time for me to move forward; I think I’ll start by checking myself for symptoms of verbal incontinence…
Ciarrochi, J. V. & Bailey, A., 2008. A CBT Practitioner’s Guide to ACT. Oakland: New Harbinger Publications, Inc..
Lovallo, W. R. et al., 2006. Cortisol responses to mental stress, exercise, and meals following caffeine intake in men and women. Pharmacology Biochemistry and Behaviour, 83(3), pp. 441-447.
Stress-Relief-Tools.com, 2009. Eustress and the Positive Effects of Stress. [Online]
Available at: http://www.stress-relief-tools.com/positive-effects-of-stress.html
[Accessed 14 October 2016].
Wilson, J. L., 2009. Cotisol & Adrenal Function. [Online]
Available at: https://adrenalfatigue.org/cortisol-adrenal-function/
[Accessed 14 October 2016].
I’m also diabetic
 The numbers in the Y-axis are arbitrary