Tag Archives: Panic

Anxiety – a monster under the bed?

We can’t escape it. The worrying thoughts. Sometimes a pounding heart or sweaty palms. At times the sense of unease. Anxiety in its various forms can be present in all of us at different times. It is called many names. Fear, panic, phobia, stress, freaking out, concern, etc. At times it arrives because of a specific event (like an examination or doctor’s appointment). For others it may be the sight of an unwanted visitor. Good morning Incy Wincy Spider!

None of us escape the experience of anxiety. It is in essence hotwired into us. Hotwired neurologically and like electricity runs through our central nervous system. But why do we have anxiety? This uncomfortable and even disabling experience. Why is it often part of our daily lives? Not everyone will agree on “daily “, but I find that the majority of clients presents with a higher or lower degree of anxiety. This is very often the case when anxiety was not their initial complaint or concern. I am thus not surprised when a referral to me is due to depression or other challenges , but it becomes clear that anxiety is part of the package.

When it comes to emotional obstacles, a major challenge can be fighting against what we can not see or what we believe “is part of whom I am”. In essence the fight can then turn against one self. Me versus I. Instead of me against anxiety. To see anxiety as the enemy is not beneficial and can be visualised (imaginative or symbolised by a real object) as the problem the requires management. And the starting point? At the beginning. Understanding how anxiety operates and why we experience it.

Step 1. Feelings of anxiety start with a trigger or catalyst. This may be a smell, seeing an external object or by internal feelings . The amygdala jumps into action by preparing us physically and mentally into a fight or flight mode. This response is triggered by the release of adrenaline into the bloodstream via the kidneys. As a result our blood pressure and blood sugar rises, muscles are fueled with energy and we focus on what may be the potential danger. This may stifle some into a passive state; others are thrown into chaotic action, while others become extremely focussed and structured.

The Shadow ManStep 2. To identify the threat or potential danger. The importance of this that we may be (1) confronted by a real danger or problem, (2) that we responded incorrectly to an external or internal stimulus or (3) that when nothing happens, uncertainty may be appear to be a threat. This step is within the context of anxiety being a survival mechanism. If not for anxiety, we would not have survived as a human beings over centuries. However, when exposed to anxiety on a regular basis or growing up in an environment where anxiety flourished, it might have become behavioural patterns and even part daily routines.

Step 3. Ask yourself, “What purpose does anxiety serve in my life?” Does anxiety enhance my experiences of love, beauty, creativeness and (importantly) logical thoughts. Does it impede in the pleasure I may gain from a loving relationship, my sleep or even my ability to complete my studies or a piece of art? What does anxiety steal from me?

Step 4. Finding ammunition to manage anxiety. Before you fire away, know we cannot rid ourselves of anxiety . We all have times when anxiety visits and times when it serves an important function. However, consider the following:

  • How many of your worries become true? If you write down your weekly worries. Say you start at the floor, write them down one for one till you reach the ceiling. How many did repeat? Then tick each one that became true. How many ticks? Interesting.
  • Stay in the here and now, the present. Anxiety often let us dwell on decisions we made (“Did I do the right thing?”, “What did they think …?”) or focus on the uncertainties of the future (so many “What if?” questions).
  • Know that your experience of anxiety does not imply something is wrong with you. Anxiety visit people from all ages, religions, cultural backgrounds. You are one of us if you experience anxiety. You are not alone. You are not the problem. Anxiety is.
  • Do you ever worry that someone will knock on your door and say, “Congratulations, you have won a wonderful holiday!” No, anxiety does not focus on possible positive outcomes. It tells us the potential bad stuff, what may go wrong and the worst possible scenarios.
  • Know that physical sensations are anxiety gearing you up for action. Your dry mouth, hairs on the back of your neck rising up, having cold feet and pins and needled in your fingers, butterflies on your stomach, shallow breathing and increased heart rate are all part of the fight or flight package. You can use it if you are under threat. But if all is fine, know that it is just anxiety being unpleasant. Know YOU WILL NOT DIE FROM THIS.
  • Breath in. Breath out. Slowly and deeply. Give your body and your brain oxygen. Breath in. Breath out.

Step 5. If you find anxiety overwhelming, find someone to talk to. This may be a friend, a family member, someone you trust (e.g. religious affiliation) or professional. So often anxiety grows on us as we keep it private. But bottling it up just let the temperature rise. Let it out, let it go. The monster under your bed is not real. It is anxiety trying to scare you.



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Filed under Psychology Reflections, This thing called life

Still standing

There should be another button. Somewhere between “PANIC!” and “ALL’s FINE!”

But there’s nothing. I need more options.

I am somewhere in between, probably more towards “ALL’s FINE!”–based upon how I feel a week after neurosurgery (or craniotomy to be precise). But should I feel like this?

There should be another button. I’m still standing, feeling quite well. Even with almost no (head) hair and a long curly scar on the left side of my head. I don’t think I’m at “PANIC!” stations though.

Maybe I am going too fast. So much has happened in our world since the 17th of May. So many new events, terminology, fears and ideas, friends and shadows came into camp with my brain tumour that I might be out of pace with the rest of the world. Not only me, but for  Anneén and I our worlds have been turned onto its head, rolled down a hill and then tripped by a guy with a long stick trying to break into our garage. So, skip back a week. Back to Monday morning, the 6th of August 2012. Breath in.

Did I tell you I am a Clinical Psychologist?” It seems like I am out of pace again, but this is relevant. Don’t panic! Since 1996 I have worked in a variety of settings, both in South Africa and the United Kingdom. Entering hospitals and frail care units have thus never been a daunting prospect. I have always carried some invisible armour with me. It was academic knowledge, clinical experience, the reliance in a strong team behind me or, in drastic situations, an open approach to whatever might be flung in my direction (luckily these were very uncommon and at worst contained old sausages). I have been with people in dark places. At times with uncontained emotions. Or memories of past events that created haunted backdrops to their lives. At times I sat with them and their stories and listened to how anxiety crippled them or kept them captive from living into their potential and the world outside perceived borders. At times, it was just physically dark and cold. But these places, situations and people with all their pasts, presents and futures were not threatening. I was OK. I was the expert to help them and had something to offer. At the very least, I could be with them. Hold a hand, be present in their darkness or consult with the staff looking after them, call in a team with expertise and care. I was OK. No need for extra buttons.

But this Monday was different. It was I dressed in a hospital frog (should that be frock?!), with blue paper pants and wheeled off to the surgery ward. The staff members and medics were now the experts. They wore the friendly smiles, knew where doors are opened, which words to say, how long to stand next to me, when to quietly move away. They were in control and I felt comforted by them. I did not need a panic button, even though I was in hospital as a “proper” patient for only the second time in my life. The first time after the May accident 10 weeks earlier. “Don’t panic”, I told myself.

My anaesthetist was quite memorable. He chatted easily with me and was humoured by my good health history. “Never had it in your life before?” he exclaimed with a puff of some theatrical bewilderment. “We do get some unusual ones, don’t we nurse!” He was warm, friendly and made the dropping off (or going under) fairly unremarkable. Especially as he softy said, just before I lost consciousness, “Sleep well”. No need for a panic button.

Tuesday 7th of August. I am awake, might have been conscious the night before, but now I knew that I woke up. Even more; I am alive and feeling alive. The light through the windows behind me was soft. I had some awareness of rain falling. I was still here, on earth. I felt grounded, for some reason. Almost automatically my left hand went in search of the scene of the intervention, the bit above my left eye. Initially I thought, “They just cut my hair!”, but the plasters reached out to my fingers. They were friendly plasters, protective and like the medics, not sending out any dramatic signals. They were not saying that everything was fine, but not to panic. I felt I was in good hands and in good plasters.

I was very bemused a few years ago in Devon (UK), when we went to see a new dentist for a check up. She was everything that she had to be, but newly qualified (which was more an issue for her than for us!). I have never been bothered much by age difference when I work with clients or patients, but I know it occasionally create discomfort. When I see my neurosurgeon, I also wonder about his age. He is younger than me, but has a relaxed and knowledgeable approach that is reassuring. He has also referred me to additional opinions and my impression is that he is not intimidated by the input of others. I like that in a clinician, as I do in other people.

His view is that the operation went well, but that we will have to follow up with radio-therapy. Unfortunately, it is not solely an oliogodendroglioma as we hoped (the rare type), but a mixed oliogodendro and astrocytoma types glioma. As a few tumour molecules stayed behind, radiotherapy is therefore indicated to take out what unfriendly cells are still with me.

It’s not the best of news, it is not panic stations either. There should be another button. Somewhere between “PANIC!” and “ALL’s FINE!” Maybe it should read, “I am still standing”. For now, that feels enough. That and the support we have received from so many.


Filed under My Brain Tumour and I, Psychology Reflections