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Dealing with anxiety

Introduction
What is anxiety?
What causes anxiety?
Anxiety and depression
How likely am I to be anxious?
How does anxiety affect people?
What are the symptoms of anxiety?
Panic attacks
Breathing control
Techniques for dealing with anxiety
Conclusion
Help and support

Introduction

Living with a lung disease can affect many aspects of your life. There are the physical symptoms, like getting out of breath and feeling tired. But lung diseases can also have an effect on your feelings, and on how you cope. Many people with a lung condition feel anxious.

This aim of this page is to help you deal with anxiety.

What is anxiety?

Everyone experiences anxiety at some time in their life. In fact, it's a normal reaction to what we think is a threat or danger to us. This can be a real threat or an imaginary one - the feeling of anxiety is the same.

People often become anxious in difficult situations, like taking an exam, moving house, having an interview or going to the dentist.

These feelings of anxiety usually go away. Sometimes, they can even be useful, making us more alert and improving our performance. But if these feelings start to take over and become a big part of our lives - that's a problem.

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What causes anxiety?

Lots of things can cause anxiety, and anxiety affects different people in different ways.

For some of us, anxiety starts after a long, slow build-up of stress. It can also start when we don't feel in control of certain aspects of our lives - our health, for example. This can make us feel anxious about the future in general.

A stressful event like a chest infection or a stay in hospital can cause anxiety. You might well be worried that it will happen again, for example.

Some medicines can make people feel anxious. And, of course, having a lung condition can give you symptoms that make you feel anxious too. Sometimes, the symptoms of lung disease - like tightness in the chest or getting very tired easily - are similar to feelings of anxiety.

It's not always clear what is causing anxiety. Sometimes, you can just be aware of feeling anxious all the time. When you can't understand why you're anxious, this can create a downward spiral: you can become anxious about feeling anxious. This makes you more anxious, and so on.

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Anxiety and depression

It's not easy to live with a lung condition. As well as experiencing symptoms such as getting out of breath and coughing, having a lung condition may make you less active than usual. It can also mean that you don't sleep as well at night. You can lose interest in food - you may get full more quickly, or you might just get tired when you eat. These are some of the reasons why people with lung disease can also be depressed.

Depression is not the same as anxiety. The difference is that anxiety is related to fear, while depression is related to feeling hopeless. Many people live with both anxiety and depression.

The British Lung Foundation produces information on depression. It might be helpful to look at that too. If depression is also a problem for you, then understanding the difference between depression and anxiety is important so that you can deal with each one separately.

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How likely am I to be anxious?

Most people feel anxious at some time in their lives. It becomes a problem when it starts to take over your life.

This is what happens:

How does anxiety affect people?

Anxiety affects people in different ways. Recognising what symptoms apply to you will help you deal with them.

Some symptoms of anxiety affect people physically, some affect how people feel or think. Have a look at the lists opposite. If some of these apply to you, you might be suffering from anxiety. If you follow some of the suggestions in this booklet then you should start to feel better and be able to get on with your life.

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What are the symptoms of anxiety?

Anxiety - affects on feelings
• A sense of fear
• Unable to concentrate
• Irritable
• Less patient than you were
• Constant worrying
• Feeling on edge all the time
• Getting very tired easily
• Bad sleep
• Feeling preoccupied or obsessed with something

Anxiety - effects on the body
• Tightness in the chest
• Chest pain
• Nausea
• Quick, shallow breathing
• Loss of appetite
• Butterflies in the stomach
• Headaches and dizziness
• Tight or aching muscles
• Rapid or pounding heart beat
• Feeling faint
• Sweating
• Passing urine a lot
• Diarrhoea
• Loss of interest in sex
• Panic attacks
• Wind
• Pins and needles, especially in the hands or around the mouth
• Trembling

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Panic attacks

Some people have panic attacks. This is when the feelings of anxiety take over. You feel like you might faint, pass out, be sick or even stop breathing. When this happens, people often 'over-breathe' or hyperventilate. This can be very uncomfortable and makes the situation worse. Learning to breathe properly can help with panic attacks.

Breathing control

There are five simple steps for controlling your breathing:

1.) Breathe out first. At the first signs of panic, the first worrying thought about a physical symptom, empty your lungs as much as you can. Breathe out so that you feel that there's plenty of room to take a full, deep breath.

2.) Breathe through your nose. This automatically slows down your breathing and helps you to avoid hyperventilating.

3.) Breathe deeply into your abdomen. Put one hand on your stomach, the other on your chest. Breathe so that the hand on your stomach moves, while the one on your chest is nearly still. By directing the breath deep into your abdomen, you stretch your diaphragm and relax tight muscles that make it seem hard to breathe.

4.) Count while you breathe. Breathe out first, then breathe ...in through your nose, counting "One… two… three". Pause a second, then breathe out through your mouth, counting "One… two… three… four". The counting protects you from rapid, panicky breathing. Make sure you breathe out for one beat longer than you breathe in. This will help you empty your lungs between breaths.

5.) Slow your breathing by one beat. Breathe in and count, "One… two…three… four"; pause, and breathe out, counting, "One… two… three… four… five". As always, you breathe out one beat longer than you breathe in.

If you can slow your breathing down at the first signs of anxiety, you can very often protect yourself from the worst symptoms.

The first times you try breathing control should be in safe and relaxing environments. Don't try it for the first time when you're panicky or even anxious. Practice is the key.

Once you feel confident that you have mastered breathing control, try it in situations where you are worried about panic, or when you first notice physical symptoms (e.g. breathlessness, pressure or pain in the chest).

If you have COPD, order our booklet COPD: Living with chronic obstructive pulmonary disease for further information on breathing control.

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Techniques for dealing with anxiety

Recognising that there is a problem is the first step to dealing with it, even if you do not know what's causing the problem. Here are some ways of dealing with anxiety:

Talking
Talking to someone about the problem can make it seem more manageable. It may help if you choose to talk to someone close to you - a friend or a member of your family. Or you may prefer to talk to someone with a similar lung condition. The British Lung Foundation support network, Breathe Easy, can help.

Most people with anxiety can be treated by their GP. Sometimes they may suggest that you see a psychiatrist or psychotherapist, or a member of the Community Mental Health team. These are all people who can help you get on your way to recovery.

Or you might prefer to call a Helpline. If so, you'll find some numbers in the ‘Help and support’ section.

Relaxation
You can try this on your own, or you may prefer to join a group. Relaxation involves sitting quietly, relaxing the muscles in your body, breathing slowly and deeply and clearing your mind of all thoughts. There are lots of relaxation tapes and books available - ask at your local library or bookshop.

Physiotherapy for your breathing can also help. Speak to your doctor or nurse about this.

Exercise
It helps to be as active as possible. This will take your mind off your anxious thoughts. Keeping active will also help to keep you fit and it can help you to sleep better. Exercise can use up the extra adrenalin that comes with anxiety.

Care for yourself
How your lung disease makes you feel is unique to you - only you really know how you feel. Learn to recognise when you are feeling over-tired or becoming stressed. Then start one of the above courses of action. It should help.

Diet
Eating a balanced diet is important (whether you have a lung disease or not!). For many people, several small meals a day may be better than two or three big ones, but content and quality are important.

For further information go here to order our Healthy eating and your lungs leaflet.

Alcohol
Too much alcohol might make you feel better for a bit, but it can actually make anxiety worse - although a small glass of sherry or wine can sometimes help with your appetite or help you to relax or sleep. It's just important not to overdo it.

You should check that alcohol doesn't clash with your medication. Ask your doctor, nurse or pharmacist, or read the leaflet that comes in the packet.

Saying "no"
Learn not to take too much on. Too many demands on your time can increase your anxiety. When you say 'no' you're taking back control of your life.

Complementary therapies
Some people find complementary therapies like hypnosis, massage and acupuncture useful. But remember not to take any herbal or other remedies without checking with your doctor, nurse or pharmacist.

For further information go here to order our Complementary therapies booklet.

Medication for anxiety
Sometimes you can use medication to control your anxiety. Your GP may prescribe something called an 'anxiolytic', which is to reduce anxiety, or an antidepressant.

Get some help or support
Joining a self-help group can be useful if you want to meet people who share your experiences. You may have a local Breathe Easy group near to you. You can meet people with similar lung conditions and perhaps pick up some useful coping strategies.

Don't be afraid to ask for help. Anxiety is more common than you think.

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Conclusion

Remember, everyone feels anxious at some time. And for people with a lung condition, anxiety is a common problem. Sometimes it can affect you for the worse. If this is happening to you, do ask for help. There are many ways of getting help and many people who can help you. The first step is deciding that you need to get some help.

Remember that taking the first step puts you on the road to recovery.

Help and support

Besides talking to your doctor or nurse there are organisations that offer help and advice:

Breathe Easy
Breathe Easy is the support network of the British Lung Foundation.

British Lung Foundation advice service
The British Lung Foundation helpline is open Monday to Friday, from 10am - 6pm and is staffed by benefits advisors and specialist respiratory nurses.
helpline: 08458 50 50 20
e: w: lunguk.org

Both of the following websites have 'useful links' pages which will direct you towards further sources of help.

No Panic
Helpline for people experiencing anxiety problems, open 10am - 10pm, 7 days a week.
93 Brands Farm Way, Randlay, Telford, Shropshire TF3 2JQ
helpline: 0808 808 0545
e: w: www.nopanic.org.uk

First steps to freedom
Information and help for people with anxiety problems, open 10 am - 10 pm, 7 days a week.
1 Taylor Close, Kenilworth, Warwickshire CV8 2LW
helpline: 0845 120 2916
e: w: www.first-step

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Page last medically reviewed: March '07

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