Understanding and managing anxiety

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If you take nothing else away…

Talk to someone

Understand anxiety better

Misunderstandings and myths

How to get the right support for you/your friend

7 problems only anxious people understand

An uncomfortable feeling of nervousness or worry about something that is happening or might happen in the future

What’s normal?

Normal, manageable, beneficial

Longer duration and Intensity/frequency

interferes with functioning and

overall wellbeing

What’s normal for cancer?

Manageable adjustment to screening, tests, diagnosis, treatment, re-occurrence worry, life-long symptoms

Trouble with adjustment, acceptance and compliance,

longer physical and emotional side effects from treatment, other mental health issues, trouble with activities of

daily living

What have we got to be anxious about?

LifeConfidenceSelf-esteemRelationshipsCommunicationWork and careerMoneyHousingHealthCaringChildren and family

CancerPanicPainFear – re-occurrence or dyingExperiencing a new situation e.g. chemo for the first timeClaustrophobiaWorries for others in our livesWorries about going off the radar (a literal FOMO)Other health anxietiesComplacency in moving forward and optimism i.e. if I feel ok I’m just going to be let down

Encouraging signs for understanding mental health and

cancer

But…

25%Mental health

30%Mental health and cancer

MILLENNIALS

I’ve probably always been anxious to a point but after my experience in hospital it sky- rocketed.

Kate, 39

Just on edge a lot, like I’m always waiting for the next bad thing to happen…it’s exhausting.

Alex, 32

I couldn’t get my feelings to change, just constantly on difficult things and wondering if I’d been a good friend, partner, daughter, colleague – it just didn’t stop.

Sally, 26

Contributing factors• Past or childhood experiences• Genetics• Diet• Physical and mental health• Drugs or medication you’re on• Every day life

Symptoms and diagnosis

Responsesnot at all =0 several days =1 more than half the days =2 nearly every day =3

Total scoresmild =5 moderate =10severe =15

A score of 10 warrants further evaluation i.e. referral/appropriate support

Anxiety misunderstandings

It’s a mental health issue

PHYSICAL

Increased heart rateIncreased muscle tension“Jelly legs”Tingling in the hands and feetHyperventilation (over breathing)DizzinessDifficulty in breathingWanting to use the toilet more oftenFeeling sickTight band across the chest areaTension headachesHot flushesIncreased perspirationDry mouthShaking Palpitations

MENTAL

Thinking that you may lose control and/or go “mad”Feeling that people are looking at you and observing your anxietyFeeling as though things are speeding up/slowing downFeeling detached from your environment and the people in itFeeling like wanting to run away/escape from the situationFeeling on edge and alert to everything around youThinking that you might dieThinking that you may have a heart attack/be sick/faint/have a brain tumour

Anxiety misunderstandingsIt’s just a panic attack

Anxiety disordersSix major types of anxiety disorders, each with their own distinct symptom profile: 

•panic disorder (anxiety attacks)•phobia•post-traumatic stress disorder (PTSD)•generalized anxiety disorder•obsessive-compulsive disorder (OCD)•social anxiety disorder

…AND subclinical

Responsesnot at all =0 several days =1 more than half the days =2 nearly every day =3

Total scoresmild =5 moderate =10severe =15

A score of 10 warrants further evaluation i.e. referral/appropriate support

Panic diagnosis

Disorder diagnosed with 1.Recurrent and unexpected panic attacks – often without obvious reason2.Attacks followed by at least one month of continuous worry or concern about having further attacks.

PTSD diagnosisDiagnosis of PTSD requires exposure to an event that involved or held the threat of death, violence or serious injury and then you experience one or more of the following signs or symptoms after the traumatic event:

•You relive experiences of the traumatic event, such as having distressing images and memories.•You have upsetting dreams about the traumatic event.•You experience flashbacks as if you were experiencing the traumatic event again.•You experience on-going or severe emotional distress or physical symptoms if something reminds you of the traumatic event.

In addition, for more than one month after the traumatic event you may:

•Try to avoid situations or things that remind you of the traumatic event•Not remember important parts of the traumatic event•View yourself, others and the world in a negative way•Lose interest in activities you used to enjoy and feel detached from family and friends•Feel a sense of emotional numbness, feel irritable or have angry or violent outbursts•Engage in dangerous or self-destructive behaviour•Feel as if you're constantly on guard or alert for signs of danger and startle easily•Have trouble sleeping or concentrating•Your symptoms cause significant distress in your life or interfere with your ability to go about your normal daily tasks.

The science and types of anxiety

Anxiety misunderstandings

It will just go away if I don’t think about it

But you’re fine/all clear/better now

Just breathe

Just think about

something else

Don’t worry, it could be

worse

Have you tried mindfulness/yoga/medication?

28%Took over a year to tell loved

ones

Support

Get a clear understanding of what it is

Find the right techniques, support, treatment

There is work to be done - body AND mind

Support levels• Self-help techniques• Talking therapies• Medication• Access to other community mental health team specialists

FROM:NHS, private, charities

THE BASICS!• Get outside when you can - walking or more vigorous exercise

• Learn a relaxation technique that works for you

• Watch your alcohol and caffeine intake• Have hobbies and good things in your life that remind you you don't always feel like this

• Get good sleep for you where possible • Talk to/be with people you trust and who make you feel good

BODY Examples

Breathing techniques Example breathing tech

nique

  Breathing technique for stress and anxiety

  Belly breathing

Drinking water Mild dehydration affects mental wellbeing

Write/Draw/Scribble Creativity in healing

Stretching Poses for anxiety

Body techniques e.g. shaking, tapping, anchor Trauma Release exercis

es (deliberate shaking)

MIND ExamplesTalk (e.g. Trusted friend, GP, Therapist/Counsellor, Anxiety Coach) How to help a loved o

ne with anxiety

  Talking with your GP about mental health

  Counselling to support anxiety

Meditation/Mindfulness Mindfulness for health

Supportive forums/groups Mind support forum

  Anxiety UK support groups

Cancer specific groups Breast Cancer Anxiety Support

  Lymphoma anxiety discussion

 Bowel Cancer anxiety information

Short-term

BODY Examples

Writing Thought diary for anxiety

  Journaling for anxiety

Drawing 3 types of art therapy for anxiety

Exercise Exercise for anxiety and stress evidence

 Exercise on prescription

Body therapiesAcupuncture access for anxiety

  EFT for anxiety

  Massage for anxiety

Medication Anxiety medications

MIND Examples

Meditation/MindfulnessMindfulness for health

VisualisationsVisualisations for anxiety

Talk (GP, Therapist/Counsellor, Anxiety Coach)

Challenging our beliefs about anxiety

 Self-help therapies for anxiety

  CBT for anxiety

Other mind-based therapies

Hypnosis/hypnotherapy for anxiety

Medication Anxiety medications

Anxiety Apps and podcasts

Anxiety coaches podcast

Charities

Cancer Research UK - fear anxiety and panic

Longer-term

A panic attack…• SLOW DOWN• Remind yourself you’re OK, it’s OK to be feel like this and it passes – you know this because experience tells you so

• Get your tool box out, take ONE ACTION AT A TIME

• Ask a friend to help you in the way you need them to i.e. NOT lots of questions

• When over – review what worked and didn’t work

If you take nothing else away…

Talk to someone

Supporting a friend

• Listen and ask• Be patient• Learn more about anxiety• Hear when they’re ready for more support and help them find it

• Manage your expectations• Get support yourself

Questions?

coaching, therapy and support for people going through challenges in health, life and self

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