Birmingham, England, Jan 30, 2023, ZEXPRWIRE, If you are a person who is afflicted with anxiety then you are most likely feeling a lot of stress as a result and experiencing physical symptoms and it can be very difficult to deal with alone, you may find yourself isolated, misunderstood and panicky.

Generalised anxiety disorder

Generalised anxiety disorder (GAD) is a common mental health condition. It occurs in approximately 4.8% of the population at some point in their lives. The symptoms include restlessness, muscle tension, irritability, fatigue, and poor concentration.

GAD has been defined as persistent excessive worry that is out of proportion to the effect of the events that trigger it. Patients report worrying about their own safety, their own health, finances, or other people.

Research into generalised anxiety disorder is increasing. Researchers have found that it is more prevalent among women than men. In addition, it is more likely to occur in adolescents than in adults.

Panic disorder

In the case of panic disorder, the symptoms include heart pounding, rapid breathing, chills, dizziness, stomach pains, and shortness of breath. You may also feel tingling or numbness in various parts of your body.

The symptoms are usually harmless but can cause a person to experience a great deal of stress. If you think you might have panic disorder, you should contact your doctor to get a diagnosis. There are a number of treatments available, including medicine, talk therapy, and cognitive behavioural therapy. Medications such as anti-anxiety medication may help, alongside therapy.

People with panic disorder report experiencing a multitude of sensations and occurrences. They have intense physical experiences, catastrophic thoughts, and social worries. These symptoms are accompanied by a number of negative self-evaluations. This can become a vicious cycle.

The best way to treat anxiety and panic is to provide timely psychological treatment. The right treatment can have a positive impact on the individual’s quality of life and on associated areas. Talking therapies are the most common form of treatment. It is important to keep track of your symptoms and find ways to avoid situations that trigger them until you’re able to resolve the issue.

Psychoeducation can provide individuals with the knowledge and skills to better cope with panic and anxiety.

Anxiety sensitivity

Anxiety sensitivity is an important risk factor for developing anxiety disorders. It consists of a tendency to perceive anxiety related bodily sensations as potentially harmful. This response may be amplified when the sensation is interpreted as a warning that something is dangerous.

Antidepressants

Antidepressants are used to treat a variety of anxiety disorders. They work by increasing the activity of neurotransmitters in the brain. Often, they take around 6 weeks to start working.

The most commonly prescribed antidepressants are citalopram, amitriptyline, and trazodone. These medications are used to treat a wide range of anxiety-related problems, such as insomnia, panic disorders, and generalized anxiety.

If you are considering taking an antidepressant, it is important to talk with your doctor. You should report any recreational or prescription drugs that you are taking, as well as any changes in your mood. Your provider may recommend different types of medication or prescribe a different dosage.

You should report any changes in your mood or thoughts of harming yourself to your doctor and or therapist, so they are able to help and support you.

Many of these medicines can have unpleasant side effects, though. A sudden stop or change in dosage can result in withdrawal symptoms, such as dizziness and headaches. It is recommended that you gradually decrease your dose over time and discuss decreasing your dose with your G.P.

Family therapy

Family therapy for anxiety helps the whole family develop tools for coping with increased levels of distress. The benefits of this type of therapy have been shown to be long lasting.

The process is designed to improve both parental and child confidence. Children and parents learn about cognitive restructuring, psychoeducation, and exposure. They also learn to engage in developmentally appropriate activities.

How to Cope with Anxiety

When it comes to coping with anxiety, there are a few things you can do. Among these are self-regulation, exercising, and interacting with positive people. There are also medications and psychotherapy to consider.

Self-regulation of breathing

When it comes to coping with anxiety, self-regulation of breathing can be an excellent strategy. Whether you’re feeling anxious about a job interview or just about something that’s bothering you: deep and slow breathing can help. In addition to alleviating feelings of stress, it can also stimulate the vagus nerve, which is an important component of your nervous system.

Exercise

Many people suffer from anxiety and exercise is an effective way to cope. Exercise can help reduce stress, boost confidence, and increase your energy level.

There are many different types of exercise. Some are better for anxiety than others. The key is to find something you enjoy doing and stick to it. You should also talk to your doctor before starting an exercise routine.

Anxiety is the result of a chemical imbalance. By depleting cortisol, exercise can improve your mood. In addition, endorphins released by exercise have an positive affect.

While most types of exercise may help relieve anxiety, some are more effective than others. Yoga is a good example. During yoga, you focus on breathing correctly.

Routines

One of the best ways to deal with anxiety is by establishing routines. This can be accomplished in many ways. Some examples include a regular sleep schedule, meditating, or even a morning ritual such as taking a stroll. These practices are great for both the mind and the body. They also help you get the most out of your day.

A good routine can take several weeks to form. You can try out different routines to see what works for you. When you do have a routine in place, make sure to reward yourself with some form of visual incentive. The best way to do this is to create a reward that is aligned with your goals.

Interacting with positive people

If you’re a socially anxious person, you’ve probably spent at least some time wondering what the best way is to interact with others in a social setting. There are many suggestions to help you achieve your goals. One of the best is a little structure. For example, one social anxiety patient can commit to introducing himself to a person in the first five minutes of a meeting. This might seem a little old fashioned, but it’s the easiest way to meet new people. For someone else, focussing on breathing and the here and now, can help alleviate their anxiety.

Another trick of the trade is to identify your key triggers. This can be done through therapy and research online.

Identifying personal triggers

Identifying personal triggers to cope with anxiety is a key component in dealing with any mental health problem. This is because triggers can lead to uncomfortable physical symptoms as well as a significant emotional reaction.

Anxiety triggers can be anything that makes you feel anxious or uncomfortable. They may include physical signs such as shaking, sweating, heart palpitations, and trembling. In addition, they may also trigger uncomfortable feelings such as irritability, frustration, and anger.

The best way to identify triggers is to keep a mood journal. Doing this will allow you to identify patterns and coping strategies. It will also help you to predict relapses and will also help you to build resilience against potential triggers.

Treatment combines psychotherapy and medications

The combination of medication and psychotherapy can be a successful treatment for anxiety.

Studies show that combining therapy and medication is more effective than either alone. In particular, it works better than antidepressant medication alone for treating major depression, obsessive-compulsive disorder (OCD), panic disorder, and social anxiety disorder.

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Anxiety disorders are some of the most common mental health conditions, and panic disorder is a specific type of anxiety disorder. Unexpected, sudden panic attacks characterize panic disorders. However, anxiety attacks are not described as an official symptom or disorder in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), the handbook most commonly used by U.S. mental healthcare professionals.

However, in contrast, the term anxiety attack is often used to describe an acute expression of someone's anxiety, brought about in anticipation of or in response to something that causes stress or worry.

This article will define panic and anxiety attacks and their causes, risk factors, and diagnostic criteria. It will also provide options for treatment and lifestyle changes to reduce and cope with symptoms.

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How Do I Know If I'm Having a Panic or Anxiety Attack?

Though they can feel similar, there are some key differences between panic and anxiety attacks. Panic attacks tend to come on quickly, often without warning, are very intense, and last only a few minutes. In contrast, anxiety attacks often occur in anticipation of something that causes extreme worry or is perceived as a danger, such as during an elevator ride.

Another difference is that panic attacks are accompanied by an intense physical reaction, such as chest tightening and difficulty breathing, and they sometimes cause a person to feel as though they are dying.

Panic Attacks

The main characteristic of panic attacks is that they come on suddenly and often unexpectedly. They involve an abrupt feeling of intense fear or discomfort that usually subsides within a few minutes. The symptoms experienced during a panic attack differ from person to person or from situation to situation.

Symptoms

The symptoms of a panic attack, according to the DSM-5, include:

  • Palpitations, pounding heart, or accelerated heart rate
  • Sweating
  • Trembling or shaking
  • Sensations of shortness of breath or smothering
  • Feelings of choking
  • Chest pain or discomfort
  • Nausea or abdominal distress
  • Feeling dizzy, unsteady, lightheaded, or faint
  • Chills or heat sensations
  • Numbness or tingling
  • Feelings of unreality or being detached from oneself
  • Fear of losing control or "going crazy"
  • Fear of dying

Causes and Risk Factors

There isn't a single cause of a panic disorder or panic attacks, and they are likely to be triggered by different things for different people. Some common risk factors include:

  • Genetics or a family history of anxiety disorders
  • Other mental health issues and diagnoses, such as mood disorders
  • Substance use issues
  • Major life stressors
  • Certain medical conditions

Diagnosis

Panic attacks are not uncommonly diagnosed in the emergency department of hospitals, as the physical symptoms, like a racing heart, chest pain, and dizziness, may prompt an assessment for possible emergency medical conditions. Though they can be scary, panic attacks are not life-threatening, and a healthcare provider can rule out medical conditions such as heart disease.

Once a physical cause for the symptoms has been ruled out, a mental healthcare provider can diagnose panic disorder and panic attacks. To diagnose a panic attack, there needs to be an abrupt surge of intense fear or discomfort that peaks within minutes, accompanied by at least four other physical and emotional symptoms.

For panic disorder, there must be recurrent attacks and a persistent concern about additional attacks or their consequences, resulting in related, maladaptive behavioral changes.

Anxiety Attacks

There are many types of anxiety disorders, such as generalized anxiety disorder (GAD), social anxiety disorder, and phobias. Anxiety disorders are typically characterized by excessive worry related to a specific situation, like being in small spaces or being generalized to many situations.

Sometimes, people will experience an onset of anxiety-related symptoms in response to, or in preparation for, a specific situation. Though an anxiety attack is not a diagnosable mental disorder, these acute symptoms may be characterized in that way.

When to Seek Support for Anxiety

Regardless of how anxiety presents, seeking mental health support is important for anyone who experiences anxiety that interferes with their daily life.

Symptoms

Each type of anxiety disorder causes different symptoms. The types of anxiety disorders outlined in the DSM-5 include:

  • Generalized anxiety disorder (GAD)
  • Panic disorder
  • Agoraphobia (a fear of certain situations or places)
  • Social phobia, also called social anxiety disorder
  • Separation anxiety disorder
  • Selective mutism (an anxiety disorder in which people, generally children, can't speak in certain social situations)

As an example, the symptoms of GAD include persistent and excessive anxiety and worry about numerous events or activities lasting greater than six months and accompanied by three or more of the following symptoms:

  • Restlessness
  • Feeling keyed up or on edge
  • Being easily fatigued
  • Difficulty concentrating or mind going blank
  • Irritability
  • Muscle tension
  • Difficulty falling or staying asleep

When a person experiences one or more of these anxiety-related symptoms, they might refer to it as an anxiety attack.

Causes and Risk Factors

A certain amount of anxiety is a normal part of life and is meant to keep us safe. Anxiety doesn't generally require treatment unless it interferes with a person's development or daily life.

Causes of excessive anxiety might include:

  • Family history of anxiety
  • Trauma
  • Chronic illness
  • Specific experiences, like a relationship ending or the death of a loved one
  • Financial difficulty
  • Certain personality traits

Prevalence of Anxiety Disorders

Anxiety disorders are among the most prevalent chronic illnesses around the world significantly impacting people's lives. Among anxiety disorders, specific phobias are the most common.

Diagnosis

Anxiety disorders each require different criteria for a formal diagnosis. However, although anxiety attacks are not outlined in the DSM-5, a mental healthcare professional might describe symptoms as an anxiety attack when they occur in anticipation of or response to a perceived threat.

What to Do During an Anxiety or Panic Attack

When acute anxiety or panic attack symptoms begin, several things can be done in the moment to help. These include:

  • Grounding exercises: Do something to keep yourself grounded in the present moment and your current environment to avoid being overcome by worry or fear. Try looking around and naming everything you see of a certain color.
  • Relaxation: Deep breathing or other relaxation exercises will help slow your heart rate and calm your breathing. Try drawing an invisible box in the air with your finger, and every time you make a new line, alternate between breathing in, holding your breath, and breathing out.
  • Distraction: Try something to take your mind off the symptoms. Getting exercise or picturing a calming place, like the beach or nature, can serve as a temporary distraction.

Treatment

Medication, psychotherapy, or a combination of both is recommended for anxiety and panic attacks.

Medication

For severe symptoms, your healthcare provider may prescribe medication. The most common and effective family of drugs for anxiety and panic disorders are selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs).

SSRIs include:

SNRIs include:

  • Cymbalta (duloxetine)
  • Effexor XR (venlafaxine)

Therapy

Research shows that psychotherapy is as effective as medication in reducing anxiety and panic disorder symptoms, including panic attacks. Though the type of therapeutic intervention and treatment plan will vary depending on the individual, the most common and effective approaches used to treat anxiety and panic disorder symptoms include:

  • Cognitive behavioral therapy (CBT): This approach examines and challenges a person's maladaptive thoughts and behaviors.
  • Mindfulness-based approaches: This approach teaches a person to become aware of the connection between thoughts, feelings, and the body and to stay in the present moment.
  • Acceptance and commitment therapy (ACT): This approach encourages techniques to change how you relate to your physical sensations and anxiety itself.
  • Panic-focused psychodynamic psychotherapy (PFPP): This approach explores maladaptive defense mechanisms and conflicts in relation to uncomfortable emotions that contribute to anxiety and panic.

Though these are the most common approaches, others may also be helpful. Work with a mental healthcare provider to determine the most effective modality for you.

Lifestyle Changes

Certain activities, behaviors, or environmental factors may contribute to worsening anxiety or bringing on panic attacks. Identifying the things that trigger symptoms can help bring some relief. Common contributors to anxiety and/or panic disorder symptoms include:

  • Caffeine
  • Smoking
  • Lack of sleep
  • Not enough physical activity

There also may be specific scenarios that bring on anxiety or panic attacks. Keeping a journal that tracks situations and symptoms can shed light on themes and patterns.

Social Support

Anxiety and panic attacks are hard to cope with alone. Research shows that having a strong social network contributes to resilience and helps protect against anxiety and panic disorder symptoms.

Summary

Panic and anxiety attacks cause symptoms that can bring about significant discomfort. Panic attacks tend to come on very quickly, often without warning, are very intense, and last only a few minutes. Anxiety attacks usually come on in response to, or anticipation of, something that causes worry or stress.

The specific symptoms of panic or anxiety attacks may vary from person to person. Genetics, family history, environmental factors, and physical or other mental illnesses can cause anxiety and panic attacks.

During an anxiety or panic attack, relaxation exercises, grounding techniques, and distraction can help ease symptoms. Long-term treatment might include medication, psychotherapy, or a combination of both. Certain lifestyle changes, like reducing caffeine and alcohol and increasing physical activity and sleep, can also help.

Frequently Asked Questions

  • Which is worse, panic attacks or anxiety attacks?

    For many people, panic attacks are more intense than anxiety attacks because they come on without warning, include more physical symptoms, and may not have a clear trigger. While panic and anxiety attacks can be highly distressing, neither are life-threatening.

  • What does a panic attack feel like?

    Panic attacks often include a combination of physical symptoms like shaking, sweating, dizziness, and chest pain, along with emotional symptoms like feelings of doom, dread, or a fear of dying.

  • How long do anxiety and panic attacks last?

    Panic attacks usually come on abruptly and commonly last a few minutes. Anxiety attacks tend to last longer and generally occur in response to, or anticipation of, something that is experienced as a possible danger or worry.

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This disorder may occur as an isolated event or, on the contrary, recur in successive periods.

Typically of rather short duration, despite its strong emotional/psychological impact, a panic attack is not medically dangerous for the person experiencing it.

An episode usually lasts between five and twenty minutes, although it may sporadically last longer.

The latter, however, typically does not exceed one hour.

During a panic attack, the anxiety level is extremely high and the person is seriously worried about his or her safety

The panic attack resolves spontaneously.

The symptoms often vanish after about twenty minutes or so, leaving the person in a state of great anxiety and alarm.

As will be discussed in more detail below, there are various techniques – e.g. breath control techniques – that make it possible to limit the duration of the attack or even prevent it from occurring.

Types of panic attacks

Panic attacks can be divided into two types:

  • unexpected, when they occur without any apparent triggering factor
  • expected, when they are related to the main features of the disorder (e.g. an arachnophobic person may develop an attack at the sight of a spider).

Most people with panic attack disorder anticipate and fear having another attack (anticipatory anxiety), so they try to avoid the places or situations that previously triggered the episode.

Panic attacks generate psychological relapses in those who experience them, both on a cognitive and emotional level and on a behavioural level

The patient may be genuinely concerned about his or her health (thinking that he or she has some serious pathology), or develop problems in the social sphere (due to the fear of being judged negatively following an episode), or lead a non-autonomous life (e.g. due to the fear of being alone during a possible new attack).

What are the most common symptoms?

Panic attack symptoms can be cognitive and somatic in nature.

They include:

  • fear of losing control
  • fear of going mad or dying
  • feeling of unreality, estrangement (derealisation), or detachment from self (depersonalisation)
  • uncontrolled crying
  • intense sweating
  • chest pain or discomfort
  • palpitations
  • flushing
  • tremors or shaking
  • choking sensation
  • shortness of breath
  • shivering
  • nausea and dizziness
  • tingling or numbness in the limbs

Clearly not all of these manifestations are present during a panic attack, as the symptoms may differ from case to case.

The frequency with which panic symptoms occur, however, defines the severity of the disorder.

Panic attacks may occur relatively infrequently, for instance once a month, or, in more severe cases, even several episodes in the same day.

In the latter case, one speaks more correctly of a ‘panic disorder’.

Panic attacks: possible causes

The causes of a panic attack are not always easy to identify and are in any case the result of a mix of psychological and physical elements.

Generally, the first attack occurs during a period of particular stress for the subject.

The source of the stress may be a single acute event or the combined action of several factors.

The most relevant causes of a panic attack may be:

  • bereavement
  • trauma
  • diagnosis of serious illness
  • major changes in emotional or working life
  • periods of overwork or lack of rest
  • conflict situations
  • financial problems

After the first episode typically the individual develops a strong worry and lives in a state of perpetual apprehension, a kind of anticipatory anxiety, based on fear of fear that inevitably increases stress levels, thus facilitating the onset of new attacks.

In essence, a vicious circle is triggered, where it is the fear of experiencing a new episode that fuels anxiety.

The latter becomes panic and a new attack is generated.

In some cases, however, panic attacks are part of a more serious disorder (such as depression, eating disorders or post-traumatic stress disorder).

How to treat panic attacks

The treatment of panic attacks may involve pharmacological treatment, psychotherapeutic treatment or an integrated approach encompassing both.

The first action to take is to recognise the problem and seek help.

Such disorders rarely disappear on their own.

Treating a panic disorder by seeking help as soon as possible prevents the disorder from becoming chronic and activating the vicious circle of fear.

After ruling out organic causes, and thus verifying the psychological nature of the episodes, one can proceed with the start of therapy.

Therapies

Pharmacological treatment is possible in the most severe and disabling cases.

There are two main categories of drugs involved in the treatment of panic attacks

  • anti-anxiety drugs and, in particular, benzodiazepines. The latter, however, should be used for short periods of time because of their undesirable effects and their ability to generate dependency and addiction
  • antidepressant drugs; SSRIs are currently favoured, referred to as ‘new generation antidepressants’ which, compared to older antidepressants, are better tolerated and have fewer side effects. In any case, it is essential to be assessed by a specialist, who can opt for the most correct and effective therapy, especially in view of the possible concomitance of other disorders.

Psychotherapeutic treatment as an alternative or in addition to drug therapy can be set up according to one of the two most commonly used psychotherapeutic approaches

  • cognitive-behavioural therapy, the aim of which is to teach patients to work on their dysfunctional thoughts, thus bringing anxiety/fears under control and modifying their behaviour so that it is no longer maladaptive, in order to regain control of their everyday life. In particular, relaxation and breath management and control exercises are recommended, the main fears are addressed, and clarification is given on the non-threatening nature of the panic attack (e.g. the person is not in danger of going mad or dying).
  • Exposure therapy: this type of treatment exposes patients to their fears so that these may diminish. The person with panic disorder is then gradually and repeatedly exposed to situations or factors that may facilitate panic attacks, always with the constant assistance of the doctor, who helps him or her manage the situation throughout the session. The goal is to let the patient relive the state of anxiety several times until, in essence, the fear loses its effect (according to the so-called habituation process).

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If you're struggling with negative thoughts or suicidal feelings, resources are available to help. In the UScall the Suicide and Crisis  Lifeline at 988; in the UK, call the Samaritans at 116 123; and in Australia, call Lifeline at 13 11 14. Additionally, you can find help at these 13 suicide and crisis intervention hotlines.


When depression and stress spike in your life, managing symptoms can feel impossible. They can impact your ability to function at work or maintain healthy relationships. But depression doesn't have to rule your life. 

If you're looking to get ahead of your depression symptoms, try implementing these coping strategies to help manage your daily depression while still thriving. 

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And for more tips to help combat depression and stress, here are six practical strategies to manage stress and breathing exercises to help relieve your stress

6 coping strategies for depression

The World Health Organization reports that approximately 280 million people in the world have been diagnosed with depression. Though depression is common, it's a serious health condition that shouldn't be taken lightly. Over 700,000 people die yearly from suicide, often resulting from depression. 

If you're feeling depressed or extra stressed, there are ways to improve your mental health and live a fulfilling life.

Acknowledge your symptoms

No one knows you better than you. Look for signs and symptoms that may be out of the norm. Here are some to look out for:

  • You're feeling more withdrawn than usual.
  • You're behaving more erratically or impulsively than usual. 
  • You're more irritable more often. 
  • You're feeling sad, lonely or hopeless. 
  • You're experiencing sleep disturbances. 

It's always a good idea to pay attention to concerns expressed by close friends and family. If the people who love you are concerned about your mental health, they may be seeing symptoms of depression you aren't aware of. 

If you're experiencing some or all of these symptoms, acknowledging that stress or depression may be the cause will help you get on the path to feeling better. 

Give yourself some grace 

Giving yourself some grace can mean different things to different people, but the general idea behind it is self-compassion. Practice extending to yourself the same compassion you show others. For example, if your friend were feeling down, what would you say? Now imagine saying the same thing to yourself in that situation. 

It's perfectly OK not to fit into the cultural norms that leave you feeling pressured, stressed or anxious. For example, it's OK if you can't attend every social event or simply don't want to (see the next item).

Keep your plans realistic

Social situations like parties and other get-togethers can sometimes add to negative feelings or even social anxiety. Depending on your situation, you may have invitations to parties with friends, work, church and other social groups. Or you may have no invitations at all. Your self-worth isn't dependent on the number of events you attend. Accept only the invitations you wish to accept and avoid overscheduling.

Sometimes the unrealistic expectations are those we set for others. Then, if they don't quite muster up, we feel disappointed. Remember to avoid setting expectations for others.

Limit alcohol

Woman refusing wine from a friend.

Peter Cade/Getty Images

Don't be fooled into thinking the sometimes relaxing effects of alcohol override the negative effects. When too much is consumed, alcohol can quickly turn from relaxing to depressing. Alcohol is a central nervous system depressant and affects mood and behavior. Even after the alcohol is out of your system, hangovers are known to increase anxiety and stress levels. 

To reduce the negative effects of alcohol, limit yourself to one to two drinks.

And you should consult your medical doctor before consuming alcohol while taking any prescribed antidepressants or antianxiety medications. 

Get active

Exercise does more for you than just keeping you fit. Working out can also be extremely beneficial for your mental health. When you exercise, your body releases endorphins. These chemicals interact with your brain's receptors and can reduce your perception of pain. Endorphins can also boost your mood and reduce stress. If you don't feel like doing a strenuous workout, walking for just 20 minutes a day can make a big difference.

Lean on your family and friends

Spending time with people you enjoy can be a wonderful mood booster. Being in the company of those we love can increase our feelings of acceptance, comfort and security. If you're feeling down, it's OK to talk with your loved ones about it so they can give you the support you need. If they know what's going on with you, they can be a better support system. 

Don't be afraid to get help

When you're showing signs of depression, help can come in several forms. But the most important thing to remember is never to be ashamed to ask for help. Whether it's talking to a loved one, seeking help from a mental health professional or discussing medication or treatment options with a medical provider, it's important to get the help you need. 

For more tips on improving your mental health, check out our tips on boosting productivity and how to declutter your life.

The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.

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TStrapped to a chair, in a gloomy basement, I do my best not to panic—breathing in for four seconds, holding for seven, and slowly releasing for eight seconds. But when a bloodthirsty monster appears at my feet and begins to crawl toward me, I don’t need a dial to tell me that my heart is pounding and that I am in imminent mortal danger.

Welcome to the future of anxiety treatment: a virtual reality (VR) game that teaches you a breathing technique to calm your nerves, then pits you against a monstrous humanoid that wants to eat you, to practice using it in real panic causative situations.

The game was developed by researchers at the University of Cambridge, with help from a local video game company, Ninja Theory, and is being tested as a means of teaching people a strategy for coping with everyday anxiety. For me, this could mean filing a story for the Guardian at extremely short notice, or trying to get out the door with two kids and already running late.

“We view anxiety as something most people experience, as opposed to a specific anxiety disorder, and try to teach emotion regulation techniques that can be useful for most people at some point in their lives,” says Lucie Daniel-Watanabe, a PhD student who leads the research.

“Therapists often ask people to teach techniques, such as breathing techniques, in totally static and disconnected ways, then say, ‘Try this while you’re stressed.’ But there’s no way to get people to try it if they’re stressed in that therapeutic situation. With VR you can completely manipulate the environment people are in, which can be very useful for that.”

With the VR headset in place and a heart rate monitor on my finger, I’m transported to a rowboat, on a calm lake at sunset. A soothing voice encourages me to inhale, hold my breath and exhale at the appropriate times, and as I feel more and more relaxed and my heart rate slows, the boat gently moves forward.

After about five minutes, I’m ready to begin the next phase of my training: the dungeon. While I know it’s just a game, the immersive nature of VR helps suspend my disbelief, and I’m surprised to hear my heartbeat pounding in my ears. In the upper corner of my vision, a small dial tells me that my heart is beating significantly faster than it was when I was on the boat, reminding me what I’m here for. I begin to slow my breathing and the dial also gradually creeps down – even hearing a fellow inmate scream, and when I look to my left I see a body being dragged back out of sight.

The humanoid monster confronts Linda Geddes in the VR game.
The humanoid monster confronts Linda Geddes in the VR game. Photo: Graeme Robertson/The Guardian

Then, suddenly, the monster stands before me, emaciated, gray-skinned and blindfolded with a terrible smile on his mouth. I’m told it can’t see me, but it can use my heart rate to sense my location; the only way to avoid death is to use the relaxation technique to lower my heart rate.

I’m doing my best, but the monster is too close and too hideous. Afterwards – after the monster jumps on me and the screen goes black – Daniel-Watanabe tells me that she deliberately put me on a harder level because many of the subjects she’s tested it on so far have been too good at avoiding death.

Striking the right balance, not to mention validating the approach with larger and more diverse groups of individuals, can take time. But other VR-based approaches are already being trialled within the NHS, for example helping people suffering from social anxiety or agoraphobia practice everyday scenarios, such as being on the street or in a shop, under the guidance of a virtual coach.

Lucie Daniel Watanabe
Lucie Daniel-Watanabe, who is leading the research, said she would never want to see VR instead of therapy. Photo: Graeme Robertson/The Guardian

Partnering with a gaming company can take such experiences to a new level. Gamifying the process can also motivate people to practice helpful techniques, such as breathing exercises, rather than relying on internal motivation — “which, when you’re in a difficult situation, can be difficult,” Daniel-Watanabe said.

While she would never want to see VR in place of therapy, “it could be a tool people could use if they were on a cognitive behavioral therapy waiting list, to learn some basic techniques in the meantime,” she said.

As for me, while I’d be reluctant to go back to that dungeon, the encounter has reminded me to breathe slowly when I’m stressed. Even an approaching deadline is no match for that monster.

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If you’re struggling with negative thoughts or suicidal feelings, resources are available to help. In the U.S, call the Suicide and Crisis Lifeline at 988; in the UK call the Samaritans on 116 123; and in Australia call Lifeline on 13 11 14. In addition, you can find help here 13 suicide and crisis intervention helplines.


When depression and stress peak in your life, it can be impossible to control the symptoms. They can affect your ability to function at work or maintain healthy relationships. But depression doesn’t have to rule your life.

If you want to get ahead of your depression symptoms, try implementing these coping strategies to manage your day-to-day depression while still thriving.

And for more tips to help fight depression and stress, here are six practical strategies for coping with stress and breathing exercises to relieve your stress.

6 strategies for coping with depression

The World Health Organization reports that about 280 million people in the world have been diagnosed with depression. While depression is common, it is a serious health condition that should not be taken lightly. More than 700,000 people die of suicide each year, often as a result of depression.

If you’re feeling depressed or extra stressed, there are ways to improve your mental health and live a fulfilling life.

Acknowledge your symptoms

Nobody knows you better than you. Look for signs and symptoms that may be different from the norm. Here are some to watch out for:

  • You feel more withdrawn than usual.
  • You behave more erratically or impulsively than usual.
  • You are more irritable.
  • You feel sad, lonely or hopeless.
  • You experience sleep disturbances.

It is always a good idea to heed concerns of close friends and family. If the people who love you are concerned about your mental health, they may see symptoms of depression that you are not aware of.

If you are experiencing some or all of these symptoms, recognizing that stress or depression may be to blame will help put you on the road to feeling better.

Give yourself some grace

Giving yourself some grace can mean different things to different people, but the general idea behind it is self-compassion. Practice extending the same compassion to yourself that you show others. For example, if your friend is feeling down, what would you say? Now imagine saying the same thing to yourself in that situation.

It’s okay not to fit into the cultural norms that make you feel pressured, stressed, or anxious. For example, it’s okay if you can’t or just don’t want to attend every social event (see the next entry).

Keep your plans realistic

Social situations such as parties and other gatherings can sometimes contribute to negative feelings or even social anxiety. Depending on your situation, you may have invitations to parties with friends, work, church, and other social groups. Or maybe you don’t have any invites at all. Your self-esteem does not depend on the number of events you attend. Only accept the invitations you want to accept and avoid over-scheduling.

Sometimes the unrealistic expectations we place on others. Then when they don’t come up all the way, we feel disappointed. Remember not to create expectations for others.

Limit alcohol

Woman refuses wine from friend.

Peter Cade/Getty Images

Don’t be fooled into thinking that alcohol’s sometimes relaxing effects outweigh its negative effects. When consumed in excess, alcohol can quickly turn from relaxing to depressing. Alcohol is a central nervous system depressant and affects mood and behavior. Even after the alcohol is out of your system, hangovers are known to increase anxiety and stress levels.

Around the negative effects of alcohollimit yourself to one or two drinks.

And you should consult your doctor before consuming alcohol while taking prescription antidepressants or anti-anxiety medications.

Get active

Sports do more for you than just keep fit. Exercising can also be very beneficial for your mental health. When you exercise, your body produces endorphins. These chemicals interact with your brain’s receptors and can decrease your perception of pain. Endorphins can also improve your mood and reduce stress. If you don’t feel like a strenuous workout, just 20 minutes of walking a day can make a big difference.

Lean on your family and friends

Spending time with people you like can be a great mood booster. Being in the company of those we love can increase our sense of acceptance, comfort, and security. If you’re feeling down, it’s okay to talk to your loved ones about it so they can give you the support you need. If they know what’s going on with you, they can be a better support system.

Don’t be afraid to get help

When you show signs of depression, help can come in a variety of forms. But the most important thing to remember is that you should never be ashamed to ask for help. Be it talking to a loved one, seeking help from a mental health professional or discussing medication or treatment options with a medical provider, it’s important to get the help you need.

For more tips on improving your mental health, check out our tips to increase productivity and how to clean up your life.

The information in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health care professional if you have any questions about a medical condition or health goals.

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If you're struggling with negative thoughts or suicidal feelings, resources are available to help. In the UScall the Suicide and Crisis  Lifeline at 988; in the UK, call the Samaritans at 116 123; and in Australia, call Lifeline at 13 11 14. Additionally, you can find help at these 13 suicide and crisis intervention hotlines.


When depression and stress spike in your life, managing symptoms can feel impossible. They can impact your ability to function at work or maintain healthy relationships. But depression doesn't have to rule your life. 

If you're looking to get ahead of your depression symptoms, try implementing these coping strategies to help manage your daily depression while still thriving. 

Health Tips logo

And for more tips to help combat depression and stress, here are six practical strategies to manage stress and breathing exercises to help relieve your stress

6 strategies to cope with depression

The World Health Organization reports that approximately 280 million people in the world have been diagnosed with depression. Though depression is common, it's a serious health condition that shouldn't be taken lightly. Over 700,000 people die yearly from suicide, often resulting from depression. 

If you're feeling depressed or extra stressed, there are ways to improve your mental health and live a fulfilling life.

Acknowledge your symptoms

No one knows you better than you. Look for signs and symptoms that may be out of the norm. Here are some to look out for:

  • You're feeling more withdrawn than usual.
  • You're behaving more erratically or impulsively than usual. 
  • You're more irritable more often. 
  • You're feeling sad, lonely or hopeless. 
  • You're experiencing sleep disturbances. 

It's always a good idea to pay attention to concerns expressed by close friends and family. If the people who love you are concerned about your mental health, they may be seeing symptoms of depression you aren't aware of. 

If you're experiencing some or all of these symptoms, acknowledging that stress or depression may be the cause will help you get on the path to feeling better. 

Give yourself some grace 

Giving yourself some grace can mean different things to different people, but the general idea behind it is self-compassion. Practice extending to yourself the same compassion you show others. For example, if your friend were feeling down, what would you say? Now imagine saying the same thing to yourself in that situation. 

It's perfectly OK not to fit into the cultural norms that leave you feeling pressured, stressed or anxious. For example, it's OK if you can't attend every social event or simply don't want to (see the next item).

Keep your plans realistic

Social situations like parties and other get-togethers can sometimes add to negative feelings or even social anxiety. Depending on your situation, you may have invitations to parties with friends, work, church and other social groups. Or you may have no invitations at all. Your self-worth isn't dependent on the number of events you attend. Accept only the invitations you wish to accept and avoid overscheduling.

Sometimes the unrealistic expectations are those we set for others. Then, if they don't quite muster up, we feel disappointed. Remember to avoid setting expectations for others.

Limit alcohol

Woman refusing wine from a friend.

Peter Cade/Getty Images

Don't be fooled into thinking the sometimes relaxing effects of alcohol override the negative effects. When too much is consumed, alcohol can quickly turn from relaxing to depressing. Alcohol is a central nervous system depressant and affects mood and behavior. Even after the alcohol is out of your system, hangovers are known to increase anxiety and stress levels. 

To reduce the negative effects of alcohol, limit yourself to one to two drinks.

And you should consult your medical doctor before consuming alcohol while taking any prescribed antidepressants or antianxiety medications. 

Get active

Exercise does more for you than just keeping you fit. Working out can also be extremely beneficial for your mental health. When you exercise, your body releases endorphins. These chemicals interact with your brain's receptors and can reduce your perception of pain. Endorphins can also boost your mood and reduce stress. If you don't feel like doing a strenuous workout, walking for just 20 minutes a day can make a big difference.

Lean on your family and friends

Spending time with people you enjoy can be a wonderful mood booster. Being in the company of those we love can increase our feelings of acceptance, comfort and security. If you're feeling down, it's OK to talk with your loved ones about it so they can give you the support you need. If they know what's going on with you, they can be a better support system. 

Don't be afraid to get help

When you're showing signs of depression, help can come in several forms. But the most important thing to remember is never to be ashamed to ask for help. Whether it's talking to a loved one, seeking help from a mental health professional or discussing medication or treatment options with a medical provider, it's important to get the help you need. 

For more tips on improving your mental health, check out our tips on boosting productivity and how to declutter your life.

The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.

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With stress levels seeming at an all-time high these days, it feels hard to get the time to decompress and de-stress. While smartphones may have their fair share of contributing to stress, there are also a wealth of apps that have the objective of helping people to relax, become more mindful, and ultimately de-stress.


Some are free and others are paid subscription services but what they share are meaningful and helpful tools, lessons, courses, and activities that try to melt the stress away. One of the perks of having a smartphone on your person at all times is that thanks to these apps, the ability to de-stress is only a touch away.

SCREENRANT VIDEO OF THE DAY

Nature Sounds Relax and Sleep

Nature Sounds Relax and Sleep

Using the gentle sights and sounds of nature, the app Nature Sounds Relax and Sleep helps relax people by playing sounds such as thunder, rain, the crackling of fire, and bird sounds among others. It has been found in a study, as reported by Healthline, that nature sounds can help reduce stress.

On the app, users can choose to set a timer that establishes how long the sound will play or users can set one of the nature sounds as their morning alarm. These relaxing nature sounds are perfect for those who love the outdoors.

Colorfy

Colorfy App

With the finding from the Academic Emergency Medicine journal that adult coloring reduced levels of anxiety, the Colorfy app is a noteworthy option for de-stressing. On the app, users digitally color their selected image or sketch of theirs that they have uploaded themselves to color. Many of the coloring pages on the app are available for free or users can buy a subscription to gain full access to the app's library.

In addition to being calming, Colorfy is also a fun and creative way to relax. For those that relax through art, there are some top-notch drawing programs to make use of.

MindShift CBT

MindShift CBT

Cognitive Behavioral Therapy (CBT) is a tool used in psychology and counseling to help change negative and hurtful thought patterns to be more logical and positive. MindShift CBT uses the teachings of CBT in an accessible and simple-to-use app.

RELATED: 10 Best Apps For Runners

Daily mood check-ins, guided relaxation, and mindfulness meditations are offered by the app as well as tips for dealing with things like general worry and social anxiety among other important topics. MindShift CBT also provides users the option to create goals and schedules.

Virtual Hope Box

Virtual Hope Box

Providing relaxation techniques, coping skills, and activities to reduce stress, Virtual Hope Box is a free app available for iOS and Android. On Virtual Hope Box, some of the stress reduction activities include games that attempt to reduce stress through distraction that utilizes a focus on gratitude.

Also, relaxing activities that use art as a means to de-stress are a great feature of the app. There are also calming photo galleries to view. If one is hoping to be less stressed in the new year, 10 apps will help those to keep their New Year's resolutions.

Woebot

Woebot

A unique stress-reducing app, Woebot aims to help users by using an AI-powered chatbot to communicate with users and guide them on how to manage distressing thoughts and feelings through CBT tenets. This free app enables communication through a text message format, having a familiar layout that will be easy to use for those on the app.

On the app, there is a range of topics to choose from, ranging from pandemic-related coping strategies to mindfulness meditation.

Serenita

Serenita

Serenita is an app that has been designed to measure stress through symptom tracking and turning the phone camera into a biomedical sensor (PPG) to look at things like heart rate, heart rate variability, and blood flow. In addition, Serenita is designed to manage stress levels through tailored five-minute relaxation exercises like breathing techniques and interactive activities.

A helpful tool offered by the app is an animated guide that teaches the user how to breathe to effectively lower stress and anxiety. Another relaxing activity for some includes listening to audiobooks, of which they should check out some of the best apps for audiobooks.

Happify

Happify

Blending principles of positive psychology, CBT, and mindfulness, Happify focuses on improving well-being and happiness through activities on the app. The games on the app are science-based and use the psychological principles that were discussed.

RELATED: 10 Best Free Reddit Mobile Apps

Thanks to the mobile capabilities of the app, stress-reducing activities can be completed anywhere. If someone is waiting in a line at the grocery store, that time could be used to do a stress-reducing activity on Happify, showing that even in a small amount of downtime, great personal growth can be worked on.

Insight Timer

Insight Timer

Insight Timer is a meditation app that is free to its users, offering over 6,000 meditations to choose from. Users can filter the meditations offered to them according to meditation type and topic, popularity, and age among other criteria. Users can also choose to customize a meditation timer with different types of ambient sounds and bells.

On Insight Timer, users can browse different topics on the app like how to sleep deeply, reduce stress, and achieve better relationships.

Pacifica

Pacifica

Pacifica uses the principles of CBT in the many features of its app. On Pacifica, users can track their feelings, work on meditation skills, build gratitude, set goals, as well as learn and practice relaxation techniques. There are audio exercises that help with things like meditation and deep breathing.

RELATED: 10 Best iPhone Apps That Nobody Knows About

Also, some activities focus on mindfulness and CBT. The relaxation function of Pacifica aims to look at soothing activities that include muscle relaxation and visualization activities.

Headspace

Headspace

An app that was proven to reduce stress by 14% in just 10 days, as reported by its website, Headspace uses science-backed meditation and mindfulness tools to support users and help them find more happiness and less stress in their lives. Some meditations aim to help with concentration and mood as well as stress and anxiety. For those who are unfamiliar with mediation, there is a beginner's course that is 10 days long.

Headspace focuses on reducing stress through meditation, where there are single meditation sessions or courses in this subscription-based app.

NEXT: 10 Best Recipe Apps For Food Lovers

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By nature, negative thoughts can easily run wild and take over our lives. Something bad someone has done in the past can go alongside worries about finances, future career moves, or our long-term health. It can be difficult to remove thoughts about the situation when something stressful is going on. You can sleep through the day or get distracted. That’s where the practice of self-soothing can help.

Self-soothing is any relaxing practice to distract ourselves from negative thinking and help us feel better. Examples could be breathing exercisesplaying uplifting music, starting a mindfulness hobby like yoga or connect with others.

One study looked at oxytocin release and self-soothing behaviors. Oxytocin, a natural hormone linked to feelings of well-being and anti-stress, is released in the brain through a range of low-intensity stimulation behaviors such as touching and caressing, but it can also be released through pleasurable situations in general. Self-soothing is the release of feel-good hormones by consciously choosing pleasurable activities.

For more mental health tips, visit how gratitude improves your mental health and tips for dealing with depression during the holidays.

Below are eight ways to practice self-soothing techniques to lift your spirits and disrupt feelings of stress.

8 self-smoothing techniques to start today

The next time you’re feeling stressed or anxious, try one of our favorite self-soothing techniques.

Use your breathing well

Try some breathing techniques to help you focus away from negative thoughts. Deep breathing and others breathing exercises can help us distract ourselves from negative thinking and increase feelings of relaxation. Some calming techniques that use breathing include:

Diaphragmatic Breathing: This exercise helps us use our diaphragm to increase deep breathing. The diaphragm is a muscle below the lungs, and using it to breathe properly is associated with lowering blood pressure and heart rate and improving relaxation, according to the Cleveland Clinic.

Practicing diaphragmatic breathing:

1. Lie flat on your back with your knees bent or supported by a pillow. Also support your head. You can also do this sitting down.

2. Place one hand on your upper chest and the other directly under your ribcage.

3. Breathe in through your nose as deeply as possible. You should feel your abdomen rise or expand, while the hand on your chest should remain fairly still.

4. Exhale through your mouth and exhale completely. Make sure the hand on your chest remains as still as possible.

5. Repeat for as long as it takes to feel relaxed or as long as you have.

Woman does breathing exercises.

Westend61/Getty Images

Square breathing: Another method is square breathing, which relies on counting to focus thoughts and get the relaxing benefits of slow breathing. With this method, you simply exhale completely. Then breathe in slowly through your nose, counting to four. Hold that breath and count to four again. Exhale through your mouth for four counts, then hold your breath again for four counts. Repeat for the duration of the exercise.

Breathe with pursed lips: Another popular breathing technique is pursed lip breathing. This technique makes you have to put in more effort to breathe, thus slowing down your breathing and helping you focus only on your breathing. To perform this technique, start by exhaling completely, then inhale through your nose for two counts. Purse or pucker your lips as if you were going to whistle. Then exhale slowly as you count to four. Repeat for as long as comfortable or necessary.

If you have a chronic or temporary nasal congestion, feel free to breathe through your mouth when the instructions ask you to breathe through your nose.

Practice the 5-4-3-2-1 technique

This is a coping mechanism for anxiety. According to the University of Rochester Medical Center, the method is based on grounding you in the present so you can focus on something other than anxious thoughts. It requires you to recognize things from your immediate environment. Use the following steps to perform the exercise:

5: Acknowledge five items that you can see around you. This can be anything from the floor to a ceiling fan.

4: Recognize four things around you that you can touch, such as your hair or the ground.

3: Recognize three things around you that you can hear, such as air coming through an oven vent or a bird outside.

2: Acknowledge two things you can smell, such as some hand lotion or you can even see what the pillow in your bedroom smells like.

1: Recognize one thing you can taste, such as a lingering food taste from lunch or a mint taste from brushing your teeth.

Use your inner dialogue for self-affirmation

This is also known as positive self-talk. We can easily fall into negative self-talk, which can be anything from beating ourselves up mentally for perceived mistakes to worrying about negative judgments others might have. Positive self-talk redirects these thoughts to a more positive mindset.

Finding a good set of self talk lines is a very personal experience. You will usually need to address specific insecurities or find expressions that resonate with you. Self-talk exercises usually involve subverting negative thoughts that make you feel down. For example, instead of thinking how embarrassed you are, remind yourself that you jumped at the chance and were brave to try.

To start with, some common and common positive Self-Talk phrases are:

“I can do it.”

“I’m good enough.”

“I can try again if I make a mistake.”

“I am doing the best I can.”

“I’m trying my best.”

Try looking for positive Self-Talk phrases and see which ones resonate with you. One or two may jump out at you, and you can try relying on them to see how they make you feel. Try as many as you need to see which sticks. Consider working with a therapist to reduce negative self-talk and work on phrases tailored to your situation.

Change the environment

Sometimes something in our environment can bring us down. It could be as simple as getting less daylight in the winter, so you could look into bulbs that mimic natural sunlight.

Sometimes, exposing ourselves to too much negative media can also turn our overall view of the negative. During the COVID-19 pandemic, a study showed that media exposure to COVID-19 news was associated with anxiety and subjective loneliness. You don’t have to cut off all stressful media completely, but it can be helpful to regulate how much you consume in a week or use tools that manage media attention, such as apps that help you limit your time on social media.

You can also work on changing your immediate environment. Repaint your walls soothing tonesredecorate your home with more uplifting and colorful decor or even plain tidy up your room can make a big difference. Play around to see which decor choices lift your mood.

Create a favorite playlist

Music can help improve our mood. You’ve probably experienced firsthand the joy of rocking out to your favorite music. Make a playlist of all your feel-good favorites.

Don’t forget to expand and try new genres, songs and artists. You may find your new favorite song that always lifts you up. Making a playlist of all new songs can also orient you in the present moment, rather than listening to a song that reminds you of the past.

Hug someone (or yourself)

Woman in white shirt hugging herself against pink background

LightField Studios/Getty Images

Above, we discussed how touch can help you release feel-good hormones. Therefore, try to make physical contact with someone you care about. Give them a hug, or even try to hug yourself.

Hugging yourself may sound strange, but it can relieve pain and improve your mood. To hug yourself, wrap your arms in whatever way feels most comfortable, place your hands on your shoulders or upper arms, and squeeze yourself for as long as you need to. You could give a hard hug if that’s what you need right now, or a softer and more soothing hug.

Try gently stroking your shoulders or forearms to get the sense of touch. You can do this while hugging yourself or not.

Try a mindful hobby

You can also look for a hobby that orients you in the present moment or is related to calming practices. For example, anything that includes deep breathing can help add feelings of relaxation, such as meditation, yoga, qigong, or tai chi. You could also try meditation apps.

Look for other hobbies that can provide a positive mood boost from getting outside, such as hiking, gardening, or biking. These activities can also be mindful if you focus as much as possible on the present moment while doing them.

Write down your feelings

Finally, try to write down your feelings, which can help us deal with anxiety, depression, and anxiety tension, according to the University of Rochester Medical Center. You could try keeping a journal of how you feel and why, and writing down ways to feel better or solve problems.

You can also find many books or articles that help you write from a prompt. These often start as questions that you then answer. They are meant to help you think and often focus on self-growth. For example, some prompts ask you to describe your perfect day, ideal home, or goals for the future. Some prompts even help you continue working social anxiety. Try searching for terrifying diary prompts.

Try some general journaling tips to help you focus on the positive things in your life. A common prompt is “Today I am thankful for…”

The information in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health care professional if you have any questions about a medical condition or health goals.

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By their nature, negative thoughts can easily run wild and take over our lives. Something nasty someone did in the past can sit right alongside worries about finances, future career moves or our long-term health. It can be difficult to remove thoughts about the situation if something stressful is going on. You might lose sleep or find yourself distracted throughout the day. That's where the practice of self-soothing can help.

Health Tips logo

Self-soothing is any relaxing practice to distract ourselves from negative thinking and help us feel better. Examples might be breathing exercises, playing uplifting music, taking up a mindfulness hobby like yoga or connecting with others.

One study looked at oxytocin release and self-soothing behaviors. Oxytocin, a natural hormone linked to feelings of well-being and anti-stress, gets released in the brain from a series of low-intensity stimulation behaviors such as touch and stroking, but it can also be released by pleasant situations overall. Self-soothing is to release feel-good hormones by consciously choosing pleasant activities.

For more mental health tips, check out how gratitude improves your mental health and tips to manage depression during the holidays.

Below are eight ways to practice self-soothing techniques to lift your spirits and disrupt feelings of stress

8 self-soothing techniques to start using today

Next time you're feeling stressed or anxious, try using one of our favorite self-soothing techniques.

Put your breathing to good use

Try a few breathing techniques to help you focus away from negative thoughts. Deep breathing and other breathing exercises can help us distract ourselves from negative thinking and increase feelings of relaxation. Some calming techniques that use breathing include:

Diaphragmatic breathing: This exercise helps us use our diaphragm to increase deep breathing. The diaphragm is a muscle below the lungs, and using it to breathe properly is associated with reducing blood pressure and heart rate while improving relaxation, according to the Cleveland Clinic.

To practice diaphragmatic breathing:

1. Lay flat on your back with your knees bent or supported by a pillow. Also, have your head supported. You can also do this sitting up. 

2. Put one hand on your upper chest and the other right under your ribcage. 

3. Breathe in through your nose as deeply as you can. You should feel your stomach rise or expand, while the hand on your chest should stay fairly still.

4. Breathe out through your mouth, exhaling completely. Make sure the hand on your chest stays as still as you're able. 

5. Repeat for as long as you feel is necessary to feel relaxed or for however much time you have.

Woman doing breathing exercises.

Westend61/Getty Images

Square breathing: Another method is square breathing, which relies on counting to focus thoughts and get the relaxation benefits of slow breathing. With this method, simply exhale completely. Then slowly inhale through your nose, while counting to four. Hold that breath, counting to four again. Exhale for a count of four through your mouth, and then hold your breath again for a count of four. Repeat for the length of the exercise.

Pursed lip breathing: Another popular breathing technique is pursed lip breathing. This technique makes you have to put more effort into breathing, and thus slows your breathing and helps you focus on just your breath. To perform this technique, start by exhaling all the way and then inhaling for two counts through your nose. Purse or pucker your lips like you're going to whistle. Then slowly exhale while counting to four. Repeat for as long as is comfortable or needed.

If you have chronic or temporary nasal congestion, feel free to breathe through your mouth when the instructions call for breathing through your nose.

Practice the 5-4-3-2-1 technique

This is a coping mechanism for anxiety. According to the University of Rochester Medical Center, the method relies on grounding you in the present so that you can focus on something besides anxious thoughts. It requires you to recognize things from your immediate environment. To perform the exercise, use the following steps:

5: Acknowledge five items you can see around you. This can be anything from the floor to a ceiling fan.

4: Acknowledge four things around you that you are able to touch, such as your hair or the ground.

3: Acknowledge three things around you that you can hear, such as air coming through a furnace vent or a bird outside.

2: Acknowledge two things you can smell, such as some hand lotion or you could even check what the pillow smells like in your bedroom. 

1: Acknowledge one thing you can taste, like lingering food tastes from lunch or a mint taste from brushing your teeth. 

Use your inner dialogue for self-validation

This is also called positive self-talk. We can easily fall into negative self-talk, which can include anything from beating ourselves up mentally for perceived mistakes to worrying about negative judgments others might have. Positive self-talk re-routes these thoughts into a more positive mindset. 

Finding a good set of self-talk lines is a highly personal experience. You'll usually have to address specific insecurities or find phrases that resonate with you. Self-talk practice usually involves subverting negative thoughts that make you feel low. For instance, instead of thinking how embarrassed you are, remind yourself that you took the chance and were brave for trying.

To start, some common and general positive self-talk phrases include:

"I can do it."

"I am good enough."

"I can try again if I make a mistake." 

"I make the best effort I can."

"I'm doing my best." 

Try searching for positive self-talk phrases and see which ones resonate with you. One or two may jump out at you, and you can try relying on them to see how they make you feel. Try as many as you need to see which sticks. Consider working with a therapist to reduce negative self-talk and work on phrases tailored to your situation.

Change the environment

Sometimes something in our environment can bring us down. It might be as simple as getting less daylight during the winter, so you might look into lamps that mimic natural sunlight.

Sometimes if we expose ourselves to too much negative media, that can also turn our general outlook towards the negative. During the COVID-19 pandemic, a study showed that media exposure to COVID-19 news related to anxiety and subjective loneliness levels. You don't need to completely cut off all stressful media, but it might be useful to regulate how much you consume in a week or use tools that manage media exposure, like apps that help you limit time on social media.

You might also work to change your immediate surroundings. Repaint your walls to soothing tones, redesign your home with more uplifting and colorful decor or even just tidying up your room can make a big difference. Play around to see which décor choices elevate your mood.

Create a go-to playlist

Music can help elevate our mood. You have likely experienced the first-hand joy of rocking out to your favorite music. Create a playlist of all your feel-good favorites.

Remember to branch out and try new genres, songs and artists. You might find your new favorite song that never fails to lift your spirits. Creating a playlist of all new songs might also orient you in the present moment, instead of listening to a song that reminds you of the past.

Hug someone (or yourself) 

Woman in a white shirt hugging herself against a pink background

LightFieldStudios/Getty Images

Above, we discussed how touch might help you release feel-good hormones. As such, try to connect physically with someone you care for. Give them a hug, or even try hugging yourself.

Hugging yourself may sound strange, but it can relieve pain and improve your mood. To hug yourself, wrap your arms around you in a way that feels most comfortable, rest your hands on your shoulders or upper arms and squeeze yourself for as long as you need to. You might give a hard hug if that's what you need right now, or a softer and more soothing hug.

Try gently stroking your shoulders or forearms to get the sensation of touch. You can do this while self-hugging or not. 

Try a mindful hobby 

You can also look for a hobby that orients you in the present moment or is associated with soothing practices. For instance, anything that incorporates deep breathing can help add feelings of relaxation, like meditation, yoga, qigong or tai chi. You could also try meditation apps.

Look for other hobbies that can add a positive mood boost by going outside, like walking, gardening or cycling. These activities can be mindful, too, if you focus on the present moment as much as possible while doing them. 

Journal your feelings 

Finally, try writing out your feelings, which can help us cope with anxiety, depression and stress, according to the University of Rochester Medical Center. You might try journaling about how you're feeling and why and write out ways to help yourself feel better or problem-solve.

You can also find many books or articles helping you write from a prompt. These often start as questions that you then answer. They're meant to help you reflect and often focus on self-growth. For instance, some prompts ask you to describe your perfect day, ideal home or goals for the future. Some prompts even help you work through social anxiety. Try searching for anxiety-busting journal prompts.

Try some general journal prompts to help you focus on the positives in your life. One common prompt is "Today, I'm grateful for…" 

The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.

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In a survey released by the World Health Organization (WHO), 301 million individuals, including 58 million children and adolescents, reported having to manage anxiety illness as of 2019. As of March 2022, globally there was a 25% increase in anxiety and depression cases owing to the Covid-19 pandemic.

What is anxiety?

Dr. Kriti Anand, Consultant Psychiatrist at Paras Hospital, Haryana, and a mental wellness expert at Manokriti Clinic, describes anxiety as “a normal response to stress.”

While explaining the concept of anxiety she added that anxiety becomes problematic when “it gets overwhelming and transforms into disorders such as social anxiety disorder, separation anxiety disorder, panic anxiety disorder, generalised anxiety disorder, and so on.”

Manage anxiety in the following ways:

  • Proper diet: Having a proper healthy diet is a must. Seasonal fruits and vegetables are a must when it comes to having a wholesome meal. Having freshly cooked nutritious food is a must for mental health for gut health plays a crucial role in maintaining mental health.

Patients who have anxiety issues, says Dr. Anand, “must avoid smoking, drinking, and avoiding intake of caffeine in any form.”

Omega 3 fatty acids are highly recommended for women to manage anxiety along with ashwagandha and green tea.

  • Active lifestyle: Dr. Kriti Anand always suggests “any kind of a workout for 40-50 minutes at least 4 days a week to maintain required health standards.” According to Dr. Amitinder Singh Dhaliwal, “With proper exercising endorphins in the body get a boost which helps in stress reduction. Strolling aimlessly also allows a person’s attention to gets diverted and release stress.
  • Maintain work-life balance: “Work must never over-shadow your free time. Not letting your career define your personality is a must, so taking time off for a vacation is a must.”, said Dr. Anand. A stressful job or a strenuous working environment can be a major trigger to manage anxiety.
  • Yoga and Meditation: Numerous medical professionals and yoga practitioners advise doing yoga poses that enable deep breathing. Longer periods of relaxation and calmness are possible with deep breathing. Deep breathing boosts the amount of oxygen reaching the brain, which further activates the parasympathetic nervous system, according to the American Institute of Stress.
  • Professional Consultation at the right time: The worst thing is to ignore symptoms. A patient with a mental illness who wishes to remain anonymous said, “It is essential to contact a specialist at the proper time to get treated. Delaying the appointment unduly makes the symptoms worse, and there is no going back from this point.
  • Massage: Massage is a method used in naturopathy to calm the body. It slows the heart rate, promotes relaxation, and makes sure that endorphins are released.

The blood circulation to the head and neck is improved, blood pressure is lowered, and hair growth is aided by massaging the temples.

  • Proper sleep: Having inadequate sleep can trigger an anxiety attack because the mind and brain haven’t rested well enough. It adds to the pressure, thus, worsening the symptoms.
manage anxiety
There can be many symptoms of anxiety. Source: Google

Symptoms of anxiety:

  • Physical symptoms: “The most frequent one”, according to Dr. Anand, is “experiencing heart palpitations, shortness of breath, chest pain or in some cases a feeling of tightness. Other symptoms could include a feeling of choking, stomach butterflies, and symptoms of irritable bowel syndrome (IBS).”
  • Psychological symptoms: For Dr. Anand, “feeling fatigued would be the most common symptom of having an anxiety disorder. Performing work routinely gets difficult for patients as they are not able to concentrate and would continue feeling anxious about minor details of life.”

Dr. Anand also mentions that “feeling anxious for some amount normal. It is also associated with betterment in performance. However, the problem arises when the same feeling prolongs for a longer period of time.”

Read More: asianatimes.com/diabetes-its-invisible-effects-on-the-kidneys-and-brain/

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Stimulating This Nerve Could Help Reduce Anxiety — Here’s How to Try It

An estimated 30% of Americans experience an anxiety disorder at some point in their lives. It goes without saying that conditions like social anxiety, a specific phobia, generalized anxiety, or post-traumatic stress disorder can interfere with your personal relationships, work performance, and other basic aspects of everyday life. And while there are lots of ways to cope with stress and anxiety, experts say stimulating your vagus nerve might be the missing piece to getting a handle on your responses to distressing events.

The vagus nerve is the longest cranial nerve in your entire body and is connected to every organ. While it supports a wide variety of critical functions — including digestion, breathing, and heart rate — it also plays a major role in the parasympathetic nervous system, AKA “rest and digest mode.”

“When the vagus nerve is stimulated, it slows breathing and heart rate, promoting calm and alleviating anxiety,” explains Chris Tompkins, a licensed therapist with Theara. “Frequent stimulation of the vagus nerve can help with emotional, mental, and physical wellbeing.”

When your vagus nerve is in working order, you're able to return to a zen state very quickly after that fight or flight response kicks in. But when certain factors sabotage your vagus nerve's functionality, you may find yourself having a harder time bouncing back from stressful or anxiety-inducing situations.

RELATED: Anxiety Symptoms

Here’s what to know about this ultra-important system — and how to stimulate it for the sake of your mental health.


What Is the Vagus Nerve?


You’ve probably heard of fight or flight — the system that gets activated when your body senses a potential threat. A wide range of scenarios can trigger fight or flight, often leaving you with a pounding heart, sweaty palms, shallower breathing, dry mouth, and nausea or butterflies in your stomach.

For instance, fight or flight might set in when you’re gearing up for a public speaking engagement when your partner starts raising their voice during an argument, or when your neighbor’s menacing dog starts barking and running towards you. If the fight or flight response serves as an important alarm system, the parasympathetic nervous system counters it by helping you return to a relaxed state once you’ve dealt with the perceived threat.

“Think of fight or flight as the gas pedal and the vagus nerve as the brake pedal,” says Jon Deam, MD, a board-certified psychiatrist and founder of Aveo Wellness. “It slows heart rate, breathing, and internal functions.”

Stefan Chmelik, an integrated healthcare physician, mindfulness coach, and founder of Sensate, calls the vagus nerve “the best tool we have for self-regulation.”

“This self-regulation capability includes physical needs, stamina, and recovery as well as metabolic, emotional, and mental balance, and stress resilience,” he explains.


How to Tell Your Vagus Nerve Needs Stimulating


When your vagus nerve is well conditioned, your body can more quickly and easily return to a calm, relaxed baseline. But what happens when it’s not functioning properly?

Deam says the vagus nerve’s capabilities within the parasympathetic nervous system can become weak when your fight or flight response is consistently overactivated.

“If stress is prolonged, such as in the case of trauma, the vagus nerve may initiate the freeze/collapse system,” explains Dana Harron, a licensed clinical psychologist, founder of Monarch Wellness & Psychotherapy, and author of Loving Someone With an Eating Disorder. “This is a stress response in which the body shuts down to conserve energy.”

According to Hong, other factors that can impact the function of the vagus nerve include:

  • Prolonged or chronic stress
  • Chronic inflammation
  • Certain medical conditions, like cardiovascular disease and diabetes
  • Genetics
  • Unhealthy diet and lifestyle

Vagus Nerve Stimulation Techniques to Try


To understand why vagus nerve exercises are helpful, it’s important to first understand what they accomplish.

“Vagal tone refers to the strength of the signal sent from the brain to the body through the vagus nerve,” says Colleen Wenner, a licensed mental health counselor and founder/clinical director of New Heights Counseling & Consulting. “When the vagus nerve is weak, the signal will not reach its destination as efficiently. People who suffer from chronic stress and anxiety tend to have lower vagal tone.”

Think of it like any muscle, says Chmelik. The more you exercise and “tone” it, the stronger it becomes.

Dr. Harold Hong, a board-certified psychiatrist at New Waters Recovery, notes that stimulating the vagus nerve can also decrease activity in the amygdala, a part of the brain involved in fear and anxiety.

To increase vagal tone, Dr. Ketan Parmar, a psychiatrist with Clinic Spots, recommends:

  • Getting adequate sleep
  • Exercising regularly
  • Getting massages
  • Practicing meditation

“Exercise has been shown to be beneficial for the vagus nerve because it helps increase blood flow and oxygenation to the brain, which can then help reduce stress and promote relaxation,” adds Parmar.

Here are some specific techniques that can help stimulate your vagus nerve:

Cold Therapy

While plunging into a bathtub full of icy water might not sound appealing, Tompkins says that cold therapy can stimulate the vagus nerve and activate the parasympathetic nervous system.

Studies have shown that cold-water immersion actually slows down your heart rate and increases blood flow to your brain, thus helping you to better cope with stress.

Not willing to take a freezing cold shower? Try just placing an ice pack on your face or dunking your face in ice water.

Humming or Singing

Parmar and Tompkins agree that the vibrations produced by singing and humming are excellent for activating the vagus nerve. This is because your vagus nerve is connected to your vocal cords — the muscles at the back of your throat that produce sound.

Try singing in the shower, humming along to music in the car, or even adding a long, deep “Om” at the end of your meditation practice. Parmar also suggests gargling with warm water for 30 seconds.

“The main aspects of the vagus nerve run through the chest into all the major organs, so creating resonance here will work on the whole body,” says Chmelik.

Breathwork

“Taking deep breaths into the belly can help stimulate the nerve, as can specific breathing techniques,” says Tompkins.

Haley Riddle, a licensed counselor with Mynd Psychiatry, recommends practicing box breathing. The technique is simple but effective: inhale for a count of 4 seconds, hold for a count of 4 seconds, exhale for a count of 4 seconds, and then hold again for another 4 seconds before repeating the cycle at least 6-10 times.

RELATED: How to Meditate

According to Harron, another strategy to try is ujjayi breathing, a common technique used in yoga. After inhaling through your nose, with your mouth closed, exhale slowly with your throat constricted as if you were trying to fog up a mirror (or impersonate Darth Vader breathing). Try to make your exhales longer than your inhales.

Progressive Muscle Relaxation

Progressive muscle relaxation (PMR) is a technique that involves tightening and then relaxing individual muscle groups one at a time. Research has shown that it can help to release feelings of tension, anxiety, and anger.

Here’s how to try PMR, according to Wenner:

  1. Start laying or sitting down.
  2. Tense the muscles in your toes for 10 seconds, then let go.
  3. Repeat this with your calves, thighs, hands, buttocks, abs, chest, arms, shoulders, mouth, and eyebrows.
  4. “As you release the tension, notice how your muscle feels,” says Wenner.

Soundscapes

Research has shown that using soundscapes — recreations of an environment through the use of sound — can be helpful for activating the parasympathetic nervous system, and help relieve stress. You can easily utilize soundscapes during meditation by turning on a recording of ocean waves, or just opening your window and listening to the birds chirping outside.

But if you’re looking to take your vagal toning up a notch, Sensate is a small wearable meditation gadget that leverages soundscapes. The device is designed to be used with a corresponding audio app that uses infrasonic waves that resonate through the body and encourage relaxation. Chmelik says you can reap the benefits of Sensate in as little as 10 minutes per day. You can use it as part of your meditation routine, or as needed when you’re struggling with an episode of anxiety — such as before a flight or presentation.

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When it comes to anxiety, everyone seems to have their own go-to solutions. While some people may opt for medication (generally coupled with therapy), others go a different route and try natural remedies for anxiety. And anxiety is quite prevalent — according to the National Institute of Mental Health (NIMH), approximately 31.1% of U.S. adults experience some type of anxiety disorder at some point in their lives. And stress can fall under all types, including generalized anxiety disorder (excessive, constant worry that lasts more than six months), social anxiety, obsessive-compulsive disorder, and post-traumatic stress disorder (to name just a few).

“Anxiety is a feeling of worry or dread about the future,” Andrea Wachter, a psychotherapist, author, and meditation teacher, tells TZR. “It can manifest as worrisome thoughts or as unpleasant physical sensations — or both.” And a number of things can bring on feelings of anxiousness and stress: You may be worried about an upcoming work review, a talk with a significant other, medical test results, and so on. Per the American Psychological Association, physical sensations could include sweating, dizziness, or a rapid heartbeat. At its worst, anxiety can interfere with your daily life and may impact your work performance and relationships, too.

Wachter says that if you’re grappling with anxiety, it’s important to remember it is not your fault — it’s the result of a variety of factors. “Nobody chooses to walk around with a pit in their stomach or worrisome thoughts in their mind,” she says. “If you are struggling with anxiety, you need compassion and support, not shame and blame.” To that end, if you’re looking for some natural ways to help alleviate your anxiety, Wachter and a couple other experts have some ideas that range from the more well-known to the surprising.

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Consume More Turmeric and Black Pepper

“Turmeric is one of my favorite spices for reducing anxiety, as it is a powerful antioxidant,” Dr. Uma Naidoo, a Harvard-trained nutritional psychiatrist and biologist and author of the bestseller, This is Your Brain on Food. “It helps the brain reduce the damaging effects of inflammatory exposures linked to increased stress.” She advises to always be sure to add a pinch of black pepper, too, as it makes the active antioxidant, curcumin, 2000% more effective.

Try Supplements & Herbs

“Anxiety can sometimes be caused by chemical imbalances, such as low serotonin levels or high chronic cortisol levels,” naturopathic doctor Sadi Jimenez tells TZR in an email. “Certain supplements and herbs can help correct chemical imbalances.” For example, ashwagandha has been shown to reduce anxiety and stress. And it comes in many forms, from pills to mushroom coffee. Adaptogen supplements — made up of plants and mushrooms — can also help lessen anxiety and boost your mood.

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Meditate

Yes, this is an obvious one. “I’ve often noted that meditation and medication are almost the same word,” says Wachter. “A regular meditation and mindfulness practice can help quell anxiety immensely.” Research, too, has found that meditation has many health benefits — in addition to helping with anxiety, it can lessen stress, depression, and insomnia, too.

Try Various Breathing Techniques

“With my patients, I see anxiety manifest when we feel out of control, usually by an external factor or future event,” Jimenez says. “Breath awareness can help, as it brings us to the present moment and we have a lot of control over how fast, and how deep, we breathe.”

Similarly, you can try breathwork yoga, Dr. Naidoo, says. As you probably guessed, it’s a form of yoga wherein you bring attention to your breath to help clear your mind. “It has been shown to modulate activity and connectivity in the areas of the brain that are involved with emotional processing, attention, and awareness,” says Naidoo. “This helps to reduce symptoms of anxiety.” She adds that focusing on breathing also acts as a means of “taking the mind off” of things that are causing stress, which will give you an improved sense of calm.

Practice ‘The Work’

In her Insight Timer anxiety courses, Wachter says she loves to provide people with a variety of tools since everybody needs different things at different times. “There are many, many moments an anxious mind needs consistent soothing and healthy redirecting,” she says. If you’re going to therapy, for example, these tools can be good to do between sessions.

“One of the best tools I know for quieting an anxious mind is called ‘The Work,’ which is a very simple, but powerful, thought-questioning process from the author Byron Katie,” Wachter adds. The process entails choosing one anxiety-producing thought at a time and asking yourself a series of illuminating, and often freeing, questions: 1) Is it true? 2) Can you absolutely know that it’s true? 3) How do you react, what happens when you believe that thought? 4) Who would you be without that thought?

So if you’re anxious about being fired, for example, you can go through each question to assess if your anxiety is grounded in reality — or not.

Do EFT Tapping

“On-the-spot techniques, like EFT tapping (also known as the emotional freedom technique) can also be effective for calming the nervous system,” says Wachter. It involves tapping on various acupressure points on the body — which someone, like your therapist, can show you, or you can learn through an online video. While you tap, you recite a statement about the issue you are dealing with.

For example, if you have anxiety about an upcoming job interview, YWCA Tucson suggests saying, “Even though I’m anxious about my interview, I deeply and completely accept how I feel.” The more you say it, the more it sinks in and helps make you less anxious about whatever situation’s been troubling you.

Practice Self-Havening

Wachter also suggests self-havening, wherein it’s as though you’re giving yourself a hug, crossing your arms over your chest. You then rub your arms in a downward motion, shoulders to elbows. The sensory input helps alleviate anxiety and calm you down. It’s as though you’re creating an internal safe haven, which can help you reprocess (and eventually escape) emotional and physical pain. “This can be very self-soothing,” Wachter says.

Go Out Into Nature

Many studies have shown that getting out in nature has many physical, and psychological, health benefits — it helps reduce stress and anxiety while boosting your mood. Plus, all the sensory input can give you something new to focus on vs. your worries.

“Getting out into nature can be soothing, as it’s akin to other practices that stimulate the vagus nerve [the main part of the parasympathetic nervous system, which helps control our mood], like humming or chanting,” Wachter explains.

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Stay Hydrated

You may know to drink at least eight glasses of water a day, but you may not realize doing so can help reduce anxiety, too. “Adequate hydration is key for mental fitness, as it promotes healthy blood flow and oxygenation of the brain, which is linked to a healthy stress response,” Naidoo explains. “Staying hydrated also helps to reduce inflammation in the brain, which is associated with fewer symptoms of anxiety.”

See A Therapist

Another solution that likely feels like an obvious one. If you’re thinking about seeing a therapist to help you manage your anxiety, Jimenez says it’s a good idea. “At the first feelings of anxiety, someone should seek out help — a therapist is a great asset to help you create tools to overcome, or prevent, anxiety,” she says. “I recommend doing so even as a preventative measure if it runs in the family.”

Wachter agrees. “A qualified therapist can certainly help guide you if you’re struggling with anxiety,” she says. They can provide you with ways to reframe anxious thoughts and give you suggestions if your mind cannot quiet down. “Whether your anxiety is situational and short-term, or if you’ve struggled with it a while, therapy can be beneficial,” she adds. And, in the interim, you can use the self-guided anxiety relief tools above.

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Anxiety is a psychological state, and it would be logical to assume that it manifests itself mainly in emotional or mental disorders, and physiology has nothing to do with it. However, there is a direct link between anxiety and bodily ailments.

It is useless to fight your brain, but it is quite possible to negotiate with it. The fact is that anxiety “hides” in everyday habits. Whether going to teen patti real cash game every day or being regularly late for transportation. Oddly enough, our brain takes them as a kind of reward, a positive reinforcement, and therefore refuses to part with them.

Before trying to change something, you must identify your nervous habits. Only after that can you gradually convince your brain that there is nothing of value in them and create a new behavior model.

Everyone will probably name a few physical signs of anxiety:

  • Chills or trembling;
  • redness of the skin;
  • increased sweating;
  • nausea;
  • rapid heartbeat.

However, those who suffer from a chronic anxiety disorder, including panic attacks, phobias, and general or social anxiety, experience more persistent symptoms, even when there is no reason to worry.

Photo by Priscilla Du Preez on Unsplash
Photo by Priscilla Du Preez on Unsplash

These conditions resemble severe illnesses, but many are unaware of their true nature. Instead, they worry that they have a heart condition, chronic migraines, or other health problems. Consequently, the anxiety escalates into neuroses and lingering stresses.

Physical symptoms.

Dizziness

A person falls into a half-fainting state as if the ground is slipping from under his feet and he is about to fall. It most often happens in a crowd or an open space. People become anxious as soon as they feel a slight faint. They are afraid of stumbling, falling, or fainting in a public place, which makes them even dizzier and increases their anxiety.

These fears often develop into a desire to avoid anything that may cause the symptom, including physical activity and strong impressions.

Chest pain

When frightened or shocked, acute chest pain is usually accompanied by a rapid heartbeat and intermittent breathing. Similar sensations occur with a heart attack, so many people fear for their lives. They call an ambulance and get frustrated with doctors when they don’t find clinical signs of a heart condition.

Meanwhile, in a study of 150 patients complaining of chest pain, 59% showed signs of an anxiety disorder. Another study confirmed that people who suspected they had a heart attack were found to have anxiety far more often than the cardiac disease.

Headaches.

Tension or “tension headaches” and migraines often indicate an anxiety disorder, although the primary factors vary.

 

  • Sleep disturbances. Most often, insomnia and other sleep problems occur against a background of nervous tension: anxious people are constantly not getting enough sleep, which can provoke a migraine.
  • Lack of serotonin. This neurotransmitter regulates our emotional state. When it is deficient, mental disorders develop, including anxiety. When serotonin levels drop drastically, blood vessels constrict, and the headache begins.
  • General stress. In stressful situations, muscles tighten involuntarily, and if this condition lingers, the body responds with a headache. In addition, emphasis is considered the most common cause of migraines.

Digestive disorders

According to medics, the reason is that nerve fibers connect the intestines and the brain. Therefore, anxiety instantly signals to the gastrointestinal tract and manifests in somatic illnesses. When nervous or anxious, many feel a fluttering feeling in the stomach or mild nausea.

However, chronic anxiety manifests itself with more severe ailments:

  • abdominal cramps;
  • diarrhea or vomiting;
  • constipation;
  • appetite disorders;
  • peptic ulcer disease;
  • irritable bowel syndrome.

The fear that vomiting or diarrhea might happen in public is morally depressing and increases anxiety. Moreover, prolonged GI dysfunction interferes with everyday life and leads to severe personality disorders.

Difficulty breathing.

In a state of anxiety, it is difficult to breathe. It manifests in various ways, from hyperventilation and rapid breathing to choking and shortness of breath. These symptoms are usually erratic. They may recur in stressful situations, danger, or nervous excitement. For example, people often feel like they have forgotten how to breathe during a panic attack. These feelings are very frightening and exacerbate anxiety disorder.

Numbness in the limbs

Anxious people describe this sensation as a tingling sensation in the numb palms, forearms, calves, and feet. It is how the body responds to general overstimulation. In response to the threat, the body reallocates resources: blood drains from the extremities and rushes to more critical organs, such as the heart.

In addition, numbness and tingling can be caused by hyperventilation. When breathing frequently and deeply, the blood becomes over-oxygenated, and the carbon dioxide level drops below normal. As a result, blood vessels narrow, and blood stops flowing to areas the body does not consider critical.

Chronic pain of unclear origin

Studies showed that 45% of patients with chronic pain suffered from an anxiety disorder. In addition, this group was found to experience more intense pain and complained more often about life.

These same people were also less tolerant of pain and were more likely to be caught in an excruciating cycle of multiple symptoms:

  • felt depressed and worried that the pain would get worse;
  • refused to do anxiety-reducing exercises because they feared they would be in pain;
  • concerned that another attack would cripple them.

In addition, it has been noted that highly anxious people who have long suffered from chronic pain often develop depression.

Consequences of anxiety

Anxiety’s emotional and physiological manifestations result from the body’s “fight or flight” response. Once the body enters this mode, hormone levels spike and trigger anxiety mechanisms.

Although anxiety serves the vital purpose of preparing to face external threats, if the body is in “fight or flight” mode too often or for too long, health problems begin to occur.

Medical research has proven a direct link between prolonged anxiety and several diseases:

  • heart attacks and other cardiovascular diseases;
  • hypertension;
  • irritable bowel syndrome;
  • chronic obstructive pulmonary disease and other respiratory pathologies.

Helpful therapies

People experiencing physiological manifestations of anxiety work with a psychotherapist who helps identify and overcome its likely causes. Specific therapies, including cognitive-behavioral and exposure therapy, teach skills to reduce anxiety in everyday situations.

In addition, therapists may offer:

  • Breathing exercises to deal with hyperventilation;
  • Coping strategies and lifestyle changes to control headaches;
  • relaxation techniques to relieve muscle tension;
  • stress management techniques to prevent psychosomatic illness.

Because the physiological symptoms of an anxiety disorder are much the same as serious illnesses, it is highly recommended that you see a specialist doctor first. Especially if you are not sure about the causes of the malaise, and only after ruling out medical problems, go to a psychotherapist.

 

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Many of us are familiar with the feeling of anxiety, especially ahead of important occasions. But those are usually one-offs, like a first date or a medical procedure. When that feeling of anxiety turns chronic and happens after specific triggers, it becomes a psychiatric disorder.

The Lancet estimates that about 76.2 million people worldwide have anxiety disorders – more than before due to the SARS-CoV-2 (COVID-19) pandemic. [1] this makes it more essential than ever that countries employ strong mental health support systems to aid people’s psychological well-being. But you can’t get treatment without first getting a diagnosis.

If you suspect you may be suffering from an anxiety disorder, here are 5 signs to watch out for.

What is an anxiety disorder?

Anxiety disorders are mental health conditions. It’s different from simple fear or nervousness, as it actively hinders your ability to function normally. There are often triggers (conscious or otherwise) that cause these feelings of panic and dread, and you cannot control your emotional response.

You may feel anxiety prior to a job interview or a significant test. Your anxiety may even be a positive response to a hazardous situation. But when that anxiety becomes chronic – or regularly triggered by some stimulus – and interferes with your daily life, that indicates a deeper underlying condition. [2]

Types of anxiety disorder

Anxiety disorders share common symptoms and manifestations, but emerge from different triggers. Some types of anxiety disorders include [3]:

  • Generalised anxiety disorder: This is a persistent feeling of unease or dread that interferes with your daily life. You may experience anxiety for prolonged periods of time, which affects your ability to function.
  • Phobias: Phobias emerge from a specific trigger, such as social situations (social anxiety), objects, or even other people.
  • Panic disorder: If a person suffers several panic attacks over a short period of time, they are diagnosed with a panic disorder.

Signs of an anxiety disorder

There are several symptoms of an anxiety disorder, which vary depending on the type of condition a person has. But here are 5 common ones that manifest in people. [4]

#1 – Feelings of panic or unease

A person suffering from anxiety will consistently and regularly feel sudden, intense panic or unease. There is usually a trigger, whether the person is aware of the trigger or not. 

For example, a person with generalised anxiety may feel triggered by their academic classes and tests. A person with social phobia may feel panicked at the thought of attending a wedding or presenting in front of their classmates and professor.

While on-off occurrences of panic and unease are normal in humans, persistent and uncontrollable panic is a sign of a genuine psychiatric issue.

A person suffering from anxiety will consistently and regularly feel sudden, intense panic or unease

#2 – Obsessive or intrusive thoughts

Intrusive thoughts tend to come out of nowhere, appearing unprompted in our minds. They may be related to the situation at hand, or they may be related to a previous experience that you suddenly remember. Intrusive thoughts tend to focus on violent or otherwise socially unacceptable concepts.

A person suffering from intrusive thoughts may get the sudden impulse to break a glass when they see one. That intrusive thought then triggers or adds to anxiety, since they recognise the wrongness of the concept and fear that they might act on it. [5]

#3 – Breathing and heart issues

Shortness of breath is a common sign of anxiety and may be a signal of an oncoming panic attack. A person suffering an anxiety attack may feel they are unable to breathe, as if their chest and lungs are constricted. In most cases it is harmless and will lift as soon as the anxiety passes.

Difficulty breathing leads to less oxygen in our bloodstream, which triggers an increased heartrate as your heart tries to pump more blood to your organs. This may also cause some chest pain and sweating. [6]

Shortness of breath is a common sign of anxiety, and may be a signal of an oncoming panic attack

#4 – Inability to calm down

For neurotypical persons, when they experience anxiety, they are often able to calm themselves down and mitigate the feeling. However, for those suffering an anxiety disorder, they are unable to regulate their breathing and lower their heartrate because the feeling is so intense and persistent.

Persons suffering an anxiety attack cannot simply “calm down” and feel better in a few minutes. The feeling of anxiety will persist, often even after the trigger has been removed or addressed.

#5 – Frequent dizziness and nausea

Shortness of breath and rapid heartbeats often lead to dizziness due to the lack of oxygen in your blood. People feel dizzy for a variety of reasons – dehydration or sleep deprivation, for example – but if your dizziness is paired with a strong feeling of unease or dread, that’s often a sign of anxiety.

Meanwhile, that fear may also trigger nausea. Your brain is experiencing a high level of stress, which affects many systems in your body – including your digestive system. You may feel like vomiting or like you’ve bloated, and you may even experience a stomach ache or acid reflux. [7]

Diagnosing anxiety

If you experience a combination of these symptoms over an extended period of time, there is a high chance you are suffering from an anxiety disorder. Speak to your healthcare provider and request that they refer you to a psychiatrist or psychologist. Your general practitioner may first attempt to rule out a physiological cause, such as a virus or bacterium.

A psychiatrist or psychologist will use specialised tests and assessment tools to diagnose your disorder. They may interview you closely and examine your symptoms to determine your diagnosis. It is especially important to emphasise the detriment your symptoms have on your daily life. [8]

Managing your anxiety

There are several strategies you can take to manage and mitigate your anxiety. Some involve self-coping mechanisms such as yoga, meditation and relaxation techniques. Adjusting your diet and exercise routines may also improve your symptoms. And of course, your psychiatrist may prescribe you medication to medically address your condition. [9]

Anxiety may affect your quality of life and ability to function, but you can take steps so it does not prevent you from living your life. If you suspect you may be suffering from an anxiety disorder based on these signs and others, consult your doctor at the soonest possible time. 

REFERENCES

[1] www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)02143-7/fulltext
[2] psychiatry.org/patients-families/anxiety-disorders/what-are-anxiety-disorders
[3] www.nimh.nih.gov/health/topics/anxiety-disorders
[4] uhs.umich.edu/anxietypanic#symptoms
[5] adaa.org/learn-from-us/from-the-experts/blog-posts/consumer/unwanted-intrusive-thoughts
[6] www.medicalnewstoday.com/articles/326831#the-connection
[7] www.healthline.com/health/anxiety/anxiety-nausea#causes
[8] my.clevelandclinic.org/health/diseases/9536-anxiety-disorders#symptoms-and-causes
[9] adaa.org/tips

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Obesity constitutes an important threat to national and global public health in terms of its prevalence and rising incidence, quality of life, life expectancy, and economic burden [1,2]. In severe obesity, bariatric surgery is the most effective therapeutic option to achieve long-term weight loss and improve the associated comorbidities [3]. This has made Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), and adjustable gastric banding the most popular and commonly performed bariatric surgeries [4]. However, a small proportion of patients have also been reported to not reach their optimum goal for weight loss two years after the procedure and very few can fail or regain the weight. While anatomical factors can play a part, behavioural and psychosocial optimizations are regarded as equally important. This includes eating patterns, depression, nutritional factors, and exercise [5,6].

Virtual reality (VR) development and applications have gained wide recognition in medical services by providing solutions to improve patients’ outcomes. This is through patients’ education, improving mental health, and post-operative care, including pain management, physical therapy, and rehabilitation [7,8]. VR is a computer-generated simulation of a real or imagined environment. It can be immersive or non-immersive according to its ability to involve the users [9]. The former has been the focus of many medical applications due to its ability to give the user control of the reproduced environment. Immersive virtual reality (IVR) is usually delivered in a variety of ways and the most popular being head-mounted displays or simply a headset [8].

We aim to provide insight on some of these immersive applications and how they can be included to enhance the patient pathway to optimize outcomes both in the pre- and post-operative period for patients undergoing bariatric surgery.

Methods

A systematic search following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) research criteria was conducted from January 2015 to December 2021. PubMed was searched using the following keywords: virtual reality, patient education, anxiety and pain, physical rehabilitation, behavioural support, obesity, eating disorders, body image, and substance cessation.

Thirty-four studies were identified and included in the final manuscript (Figure 1) supporting VR technology across applications that can be applied to bariatric patients’ surgical pathways. The applications were subcategorized into eight different areas of interest, which can help to shape the concept of the virtual ecosystem of bariatric patients (Figure 2).

Results

VR applications have been described in the eight domains mentioned below, which can be applied in relation to patients undergoing bariatric surgery.

Virtual Reality Patient Education (VR PE)

VR education has been introduced to make the information more meaningful and patient-centred by enabling its users to be fully immersed in an interactive simulated and self-controllable visual and auditory experience [10]. In a study by Pandrangi et al. [11], VR was found to be a useful informative tool in educating patients about their aneurysmal disease through interactive reconstructed three-dimensional (3D) images of their aortic anatomy. The majority of the patients in this study agreed that VR 3D anatomy helped to improve their understanding and therefore felt more engaged in their healthcare decisions [11].

VR PE has also played a role in improving the stress levels of patients undergoing radiotherapy (RT) by improving clarity and levels of education about their treatment. A randomized study on 60 patients with chest malignancy showed that patients who received VR PE showed significant improvement in comprehension and reduction in stress and anxiety levels when compared to standard education [12]. Another study on 43 patients utilized VR PE by creating 3D images of patients in RT sessions and what to expect during the treatment. After the VR PE, 95% of patients agreed that they had a clear understanding of how they would feel when lying on the treatment table. Also, patients’ understanding of the location and the size of their cancer had significantly improved from around 50% to 95% with an increase in the orientation of side effects of the treatment by 30% post-VR PE [13].

In bariatric surgery, there is no currently reported data on the applications of VR education. However, the potential impact of VR PE can be numerous across the weight management pathway. Preoperatively, bariatric patients could potentially utilize VR to be virtually educated about different surgical options versus conservative treatment through enhanced 3D interactive images. This could be seen to help in better understanding of their options including surgery and thereby enhancing informed consent and overall education.

Post-operatively, VR-enhanced education could provide an option for daily or weekly updates on lifestyle changes, which could help in improving compliance. Importantly, this can be done from the comfort of the patient’s home with the added advantage of reducing costs and time for travelling to attend appointments.

Anxiety Related to Surgery

A significant amount of anxiety related to surgery is due to the fear and uncertainty of the outcomes. Its psychological and physical effects are associated with longer recovery, an increase in the need for analgesia, anaesthetic requirement, and unfavourable behavioural and emotional outcomes [14]. Conventional methods of mitigation of preoperative anxiety are pharmacological and non-pharmacological strategies [15].

Recently, with promising results in the management of anxiety and other psychiatric disorders, VR has been successfully applied to reduce anxiety related to surgery in different surgical settings [16]. Chan et al. [17] tested the effect of VR relaxing meditation and breathing exercises on 108 women undergoing hysteroscopy. This showed that anxiety scores were significantly reduced after the 10 minutes of VR content, which helped in reducing pain and stress related to surgery. Also, around 85% of patients reported the VR experience as good or excellent [17].

In minimally invasive abdominal surgery, Haisley et al. [18] used VR meditation as a perioperative tool with favourable results in reducing pain, anxiety, and nausea and around 75% of patients stated that they would use the VR again [18]. Similarly, VR meditation showed favourable results in reducing pain and anxiety in burns and complex pain [19,20].

The rationale for using VR to improve anxiety preoperatively is by immersing patients in a fully simulated relaxing environment with the objective of placing them in a more empowered state to deal with the triggers of their anxiety [21]. This could be applied to the bariatric population before surgery. It is to be seen from future studies whether these expected results can be validated in bariatric patients. There is therefore the potential for obtaining better evidence for patient satisfaction and reducing stress related to bariatric surgery.

Pain Management

Successful pain management is a key element of the post-operative course as it shortens recovery and reduces risks of cardiovascular and pulmonary complications. In bariatric surgery, pain management is essential to enhance recovery and prompt early mobilization, which helps to decrease venous thromboembolism, prevent other events, and reduce hospitalization [22]. Therefore, a multimodal approach through regional and systematic analgesia is considered the most effective method as it minimizes opiate use, which can induce obstructive sleep apnoea, which is more liable due to the co-morbidities of obesity [23].

Applications of VR in pain management in other surgical patients have been reported to have numerous benefits. This includes a reduction in pain scores after cardiac, knee, abdominal, and spinal surgery with overall patients reporting the use of VR as a pleasant experience and stating that they would use it again on further occasions [18,24,25]. VR pain management follows a similar concept to VR and anxiety meditation by immersing patients in a simulated relaxing environment, which can help to divert the patient's feelings from their pain. This could be playing a major role in bariatric patients' management of pain and anxiety related to surgery with proper application integration in their peri-operative pathway.

Optimizing Pulmonary Function for Surgery

Respiratory function in morbidly obese patients follows a restrictive pattern with up to 77% suffering from obstructive sleep apnoea [26]. This increases the risk of impaired post-operative oxygenation and other respiratory complications in the form of atelectasis. Optimization of pulmonary function for surgery includes smoking cessation, breathing exercises, including inspiratory muscle training, incentive spirometry, and optimization of chronic disease, for example, asthma and chronic obstructive pulmonary disease (CPOD) [27].

With the increase of applications of VR in different rehabilitation programmes, VR has been aiding in pulmonary exercises in both healthy individuals and COPD patients [28,29]. VR pulmonary rehabilitation is designed to enable home-based exercises in the form of a 3D avatar instructor in an immersive relaxing environment to guide patients through breathing exercises based on traditional rehabilitation programmes [30]. In COPD patients, VR-based respiratory rehabilitation has shown to have similar outcomes when compared to a conventional programme with the additional benefit of performing the exercises from home. Moreover, VR showed enrichment of experience by also decreasing the levels of anxiety during exercise and therefore optimizing cardiorespiratory function [31].

Physical Fitness Applications

Pre- and post-operative physical activity (PA) is regarded as an important element in enhancing recovery after surgery as it improves physical state, responses to stress from surgery, and improvement of cardiovascular function, thereby reducing complications [32].

In the bariatric population, a structured exercise regime is considered a feasible and effective adjunct therapy that benefits cardiometabolic parameters when compared to those with bariatric surgery alone [33]. Exercise before surgery has shown to be beneficial in reducing body weight, improving blood pressure, general fitness, quality of life satisfaction, and decreasing fasting plasma insulin and blood lipid. Exercise after bariatric surgery has been shown to preserve dynamic muscle strength and contribute to maintaining weight loss after calorie restriction [34].

Although PA promotion is recognized as an important component of weight loss programmes, there are no current evidence-based or standardized bariatric surgery-specific PA guidelines [35]. Reported exercise regimes ranged from walking, aquatic, resistance, and supervised exercises. Also, adherence to exercise before and after surgery plays a big role in physical rehabilitation. As in the bariatric population, many can face barriers in the form of low confidence levels in their abilities and not feeling comfortable going to the gym due to real and perceived discrimination. Therefore, many come up with the belief of not having time to participate in sports [36].

VR rehabilitation has gained much recognition from dedicated platforms like treadmills, diving, cycling simulators, and medically oriented VR rehabilitation. These studies have demonstrated increased participation of users utilizing VR exercise programmes [37]. VR rehabilitation and exercise have shown to be effective in healthy individuals and different medical rehabilitations. It was reported to be equivalent and sometimes more superior to standard physiotherapy in cerebral palsy, spinal injury, and stroke [38]. In healthy individuals, VR exercise was demonstrated to increase adherence and enjoyment with positive physiological effects during exercise [39]. It was also reported that obese children performed better on treadmills while using VR than traditional walking, as VR allowed more distraction and less discomfort [40].

VR exercises during rehabilitation can therefore potentially play a major role in pre- and post-operative PA improvement in bariatric patients. Given the feasibility and the safety of these home-based devices, it can decrease the load on healthcare services, as most of the standard pre-operative programmes are resource intensive.

Virtual Reality and Enhanced Cognitive Behavioural Therapy

Eating and depressive disorders significantly affect the bariatric population with a prevalence of 24% and 17%, respectively. Both can lead to less post-operative weight loss, weight regains, impaired general psychology, and quality of life [41]. Cognitive behavioural therapy (CBT) is recommended for patients undergoing weight loss surgery (WLS). It has been shown to improve self-monitoring and control eating behaviours with significant improvement in depression and anxiety and therefore better results [42].

Over the last decades, VR-enhanced cognitive therapy (VRCBT) has been embraced for being a novel way to deliver CBT. The technique creates an interactive 3D environment to simulate successful goal achievement. This helps patients to overcome memories of previous real-life experiences through emotionally guided virtual exposure [43]. VRCBT has shown favourable results in anxiety, phobias, social anxiety disorders, and depression [21]. Moreover, randomized trials have shown VRCBT to be superior to conventional CBT in managing eating disorders and binge eating [44,45]. This helped in weight reduction therapy and adding adherence to programmes [46].

There is a paucity of evidence of the use of VR in the overweight and morbidly obese population. Phelan et al. [47] tested the use of a VR environment on 15 overweight adults for four weeks with the main hypothesis to evaluate the effect of the simulated scenes on behavioural skills related to eating habits. Although they showed no difference in weight loss among participants, VR intervention was more preferred by patients over traditional weight loss programmes [47]. Manzoni et al. [45] tested the efficacy of an enhanced VRCBT module aimed to unlock the negative memory of the body and modify its behavioural and emotional behaviour. A total of 163 female morbidly obese inpatients were randomly assigned to three CBT-based treatments: a standard behavioural inpatient programme (SBP), SBP plus standard CBT, and SBP plus VR-enhanced CBT. The study showed that patients in the VR group had a greater probability of maintaining or improving weight loss at one-year follow-up than SBP patients and, to a lesser extent, CBT patients. On the contrary, participants who received only a behavioural programme regained on average most of the weight they had lost [45].

VRCBT can therefore be a valuable tool in managing behavioural disorders related to obesity in patients undergoing WLS. This can help in maintaining weight loss and improving well-being and quality of life.

Virtual Reality and Body Image (VRBI)

Body image disorders (BIDs) are linked to various psychological and physical sequelae of impaired functions, for instance, depression, anxiety, eating disorders, and poor quality of life [48]. Among the bariatric population, body image dissatisfaction is associated with binge eating, depression, and lower self-esteem, with one in five bariatric patients identifying appearance as their main motive for surgery [49]. Improvement in body image perception after successful surgery has been linked to a decrease in compulsive eating syndromes, reduction in body mass index (BMI), and improvement in self-esteem and intimate relationships [50].

A contrary aspect of body image after surgery includes the issue of excess skin with massive weight reduction. This has been linked to poor body satisfaction, dermatitis and skin fold irritations, and impairment in daily activities and exercise. In turn, this leads 85% of bariatric patients to seek body-contouring surgery (BCS) to elevate this problem [51].

The application of VR has been used to improve BID. This is by creating a 3D simulation of their bodies in the form of avatars through an immersive environment that reproduces situations related to their body image concerns. Through multisensory simulations, it produces an empowered feeling of ownership of one’s body, which consequently promotes a healthier body image and behaviour [52]. A recent systematic review of six studies utilizing avatars and VR in weight loss programmes showed that avatar-based interventions were effective in both short- and mid-term weight loss. Also, the technology helped to improve exercise adherence in the long term [53]. VR was also used to assess the BID of 78 women with different BMIs by exposing the participants to different versions of avatars: slimmer, same weight, and overweight. The study showed that women with higher BMI reported more BID on their replicated avatar and showed satisfaction with their slimmer version. This finding indicated that VR may serve as a novel tool for measuring BID [54].

Potentially, VR avatars can also play a role in body image perception in bariatric patients. It can be integrated to improve BIDs by recreating slimmer avatars, which could promote adherence to weight loss and exercise programmes.

Smoking and Alcohol

While the increase in BMI is a risk factor for adverse outcomes related to surgical procedures, smoking's hazardous effects range from increased risks of pulmonary complications, wound infection, venous thromboembolism, and slower recovery. Similarly, alcohol consumption before surgery can lead to increased unfavourable outcomes [55]. Smoking and other substance abuse are recommended to be stopped four to six weeks pre-operatively [56]. VR has been tested as a potential solution to stop smoking and alcohol usage by inducing an advanced cue exposure therapy (CET), which was superior to static images or videos used in conventical settings [57]. Also, VR exposure therapy (VRET) has been reported to be more effective if combined with conventional cognitive behaviour therapy in relation to stopping smoking [58].

Although its applications are still under development and validation, VRET in smoking and alcohol cessation could play an important role in optimizing patients undergoing bariatric surgery as a part of a virtual reality surgical care package (VRSCP).

Discussion

Patients who are candidates for WLS usually undergo variable preparatory phase and post-operative optimization to improve both short- and long-term results. Standard care models usually involve education and follow-up through multidisciplinary teams with reflection on the patient's progress through educational sessions and follow-up plans.

While VR applications are being investigated in many surgical and medical specialities, their application to patients undergoing WLS is limited and not yet explored. The favourable applications of VR in patient education, anxiety and pain management, preoperative optimization, and behavioural and physiological treatment can be packaged as a surgical care bundle making bariatric patients' journey more satisfactory with the potential for improved outcomes.

Despite its promising applications, VR is still an emerging technology and has its own initial drawbacks to gaining traction in the healthcare system. There are several reasons for this. Firstly, the obvious cost of the systems and the absence of adequate clinical validation could play a major role in limiting widespread adoption. Further delays in adoption would likely be seen within the education of both healthcare providers and their patients, particularly on the application and utilization of the systems. The technology is still seen to be clumsy to wear and will need educational support to use [59].

With the increased investments and advancement in VR technology, education of healthcare professionals and further studies demonstrating evidence of improved outcomes, VR will play a major role in surgical patients and more specifically bariatric patients. This could be even refined as a personalized surgical care package. This will contribute to a fully virtual ecosystem in health care.



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Anxiety is everywhere and touches every family. Way back in 2018, Barnes & Noble reported that sales of books about anxiety were surging, and that was before anyone had ever heard of masking or social distancing. In the years since the pandemic, the need for concrete tools to combat uneasiness, apprehension and excessive nervousness has only become more critical, with an estimated 25% increase in the prevalence of anxiety, especially among women and young adults.

"The mental health crisis is real," says Ellen Hendriksen, Ph.D., a clinical psychologist and author of How to Be Yourself: Quiet Your Inner Critic and Rise Above Social Anxiety. "The clinic I work at has experienced the longest wait list we've ever seen in our 25-year history." Dr. Hendriksen adds that the average age of the patients she sees is skewing younger and younger, with many college students now seeking her help.

While anxiety is best treated with counseling and medication, self-help books can also be beneficial when it comes to complementing traditional treatment, and they can also provide some good ways to stop feeling anxious while you wait for an opening with a therapist. "A strength of self-help books is their versatility," says Joshua Magee, Ph.D., a clinical psychologist and founder of Wellness Path Therapy. "You can use them rather inexpensively at your own pace, which can be useful for people who aren't currently working with a therapist. It's just important to check that they are rooted in scientific evidence," he adds.

Ramani Durvasula, Ph.D., a licensed clinical psychologist and author of Should I Stay or Should I Go? Surviving a Relationship With a Narcissist, recommends anxiety books to patients for their useful tools: "Self-monitoring, practicing breathing and mindfulness exercises you can do at home — people can see what works and what doesn't, and they become a really useful way to extend the work of therapy to the time in-between," she says.

“You might come away from a good self-help book with a changed attitude, different behavior, fresh motivation or something else shiny and new to test-drive,” says Dr. Hendriksen. She says that a solid anxiety self-help book meets three criteria:

  • It articulates a feeling or experience you've carried for years but couldn’t identify.
  • It shrinks shame and isolation.
  • It encourages you to move forward.

    How we chose the best books about anxiety:

    We went straight to the experts for this one: We asked seven mental health professionals to name the books that they recommend most to their clients — and that they have found helpful themselves. Our health editors have vetted that these book recommendations are all based on reliable scientific research.

    Our top picks:

    If you're struggling with anxiety, read our full reviews of the top recommendations below; you can find more information about what to look for in books about anxiety, as well as coping mechanisms that work and when to see a professional about anxiety, at the bottom of this guide.

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Best Overall Anxiety Book

New Harbinger Publications

The Anxiety & Phobia Workbook

Best for Dealing With Stress

The Stress-Proof Brain

Best for Perfectionists

Free Press

Never Good Enough: How to Use Perfectionism to Your Advantage Without Letting it Ruin Your Life

Best for Sensitive People

The Highly Sensitive Person

Best for a Loud Negative Inner Voice

Chronicle Prism

Detox Your Thoughts: Quit Negative Self-Talk for Good and Discover the Life You've Always Wanted

Best for Catastrophizers

The Worry Trick

Best Practical Tools for Anxiety

The Anxiety Toolkit

Best for People Who Experience Panic Attacks

Mindfulness Workbook for Panic Attacks: Healing Strategies to Reduce Anxiety, Manage Panic and Live in the Moment

Best for People Who Experience Negative Thoughts

New Harbinger Publications

The Negative Thoughts Workbook: CBT Skills to Overcome the Repetitive Worry, Shame and Rumination That Drive Anxiety and Depression

Best for Anxiety About Health

Freedom from Health Anxiety: Understand and Overcome Obsessive Worry about Your Health or Someone Else’s and Find Peace of Mind

Best for People Pleasers

Please Yourself: How to Stop People-Pleasing and Transform the Way You Live

Best for Chronic Worriers

When Panic Attacks

Best to Find Balance

Better Than Perfect

Best for Learning Mindfulness

Full Catastrophe Living

Best for People With OCD

Getting Over OCD

Anxiety is a psychological state in which you may feel worried, tense and have physical signs such as increased heart rate or sweating, according to the American Psychological Association.

You might feel anxious about something specific in the future, or feel a more diffuse sense of anxiety. "For some people it's a very physical feeling, and in some people it shows up as being unable to sleep," while others still avoid engaging in activities about which they have a lot of anxiety, says Debra Kissen, Ph.D., M.H.S.A., chief executive officer for LightOnAnxiety CBT Treatment Centers and the co-author of four books on anxiety, including the upcoming Overcoming Parental Anxiety: Rewire Your Brain to Worry Less and Enjoy Parenting More. "It's important to know how it shows up in you so you can recognize it in yourself."

What is the best coping mechanism for anxiety?

There is no single best way — different things work for different people, says Kissen. "When you're on anxiety, it's a fight-flight-freeze response, because your brain is thinking 'danger!'" she says. One helpful way to cope in the moment is to do something with your body, such as take a brisk walk, jump up and down or dance, "to do something to relieve the energy," she says.

Another good coping mechanism for anxiety is to took around to reassure yourself that you are no in actual danger, even though it feels that way. "Is there a lion coming? Are my pants on fire? Is there an immediate danger?" Kissen asks hypothetically. "If nothing is actually occurring, then that's a false alarm." Realizing that can give you space from the emotion.

Once you've recognized that you're feeling anxiety, you might try repeating a helpful mantra, such as "this is a false alarm," or "this feels uncomfortable but I am teaching my brain I can handle this." Kissen advises having your helpful mantra handy as an in-the-moment reminder.

Breathing slowly and deliberately can also help dial down some of the physical reaction to anxiety, say experts, as can focusing on fidget toys.

Can reading cure anxiety?

Anxiety is a normal human emotion, not something you'd want to "cure," but self-help books can be calming when your anxiety feels excessive.

Not only are research-based solutions useful in reducing anxiety, it's comforting to have a manual handy when you're having a moment. A reputable book on anxiety "is like having an on-demand therapist that can offer you instant support," says Kissen. But unless your anxiety is pretty mild, it's unlikely a book on its own will be enough to really get it under control, she says. "It's really hard to change on your own," she says. "It's hard to be the coach and the one who needs the coaching."

Still, as part of a treatment plan, it's a great tool. "A book is an additional tool in the toolbox, especially when an anxious brain is driving the moment, because it can offer a more balanced perspective," says Kissen.

What to look for in books about anxiety

Ask yourself if you fit into one of the targeted audiences of the books on our list. For example, have you been told you're a perfectionist? That you're "too sensitive"? Note: If you choose a workbook, order a hard copy (not an audiobook) and don't forget to grab a pencil, because a number of these reads require note-taking and have actionable exercises.

When to see a doctor about anxiety

It's time to see a doctor about anxiety when it is getting in the way of your happiness, or if you're not functioning well. "If you're not meeting your life requirements at work or at school or in terms of taking care of the kids," it is time to consider getting help, says Kissen.

It may also be that you're not enjoying your life as much as you might if anxiety were less of a factor. "If your anxiety is causing you distress, or if you're anxious more days than not or more stuck in the anxiety than engaging in your life, why not have all the tools in the toolbox at your disposal?" she says.

"If you find a book you really like, it's a good idea to bring it to your therapist," she says, so you can focus on ways to alleviate your anxiety.

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For the first time, the US Preventive Services Task Force has recommended that all US doctors should screen adults 19 to 64 for anxiety, even without symptoms. Anxiety disorders are the most common mental health struggles people face. The draft decision references a systematic review highlighting the benefits and effectiveness of mental health screenings. Early intervention for anxiety can have a signifiant impact on a person's ability to manage symptoms and function. 

The proposal is open to public comment until Oct. 17, so there's no firm date that the recommendation could be implemented. In the meantime, here's how to manage anxiety each day.

Read More6 Best Teas for Anxiety and Stress for 2022

Can you really get rid of anxiety? 

You might have come here to learn how to get rid of anxiety fast. However, anxiety isn't an old item you can just toss to the curb. If you live with anxiety, you might be dealing with a diagnosable mental health condition that will likely be a part of your life long-term. It can take many forms -- like social anxiety or a phobia. In any case, learning how to deal with anxiety means figuring out how anxiety affects you personally.  

To find out if you're living with generalized anxiety disorder, the most common type of anxiety, Mental Health America has a free online screening tool that you can use. 

Whether you want to figure out how to get rid of social anxiety, GAD, panic attacks, phobias or another way that anxiety is impacting your life, it starts with learning your triggers. That means identifying your symptoms and what causes them, so let's start there. 

woman practicing meditation at home

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What are the symptoms of anxiety? 

The symptoms of anxiety depend on the type of anxiety affecting you. The five most common types are:

  • GAD
  • Obsessive-compulsive disorder 
  • Panic disorder
  • Post-traumatic stress disorder 
  • Social anxiety disorder

If you want to learn how to get rid of anxiety, it's worth doing some research to find out what type could be affecting you and the symptoms it causes. Talking to a doctor can help, too. 

That said, since GAD is the most common form of anxiety and many of its symptoms apply to other anxiety disorders, we look at those here. Before we dive in, you should know that anxiety looks different for everyone. Symptoms vary and it can be challenging to tell if you're living with a diagnosable anxiety disorder or whether you just need new tools for dealing with stress. 

Ultimately, knowing what symptoms to look for can help you decide if it's time to talk to your doctor. Anxiety can manifest both physically and mentally so let's look at both. 

Physical symptoms of anxiety:

  • Headaches
  • Fatigue
  • Stomach aches
  • Excessive sweating
  • Nausea and digestive problems
  • Sleep problems
  • Achy or tense muscles

Psychological symptoms of anxiety:

  • A pervasive sense of worry that you can't control
  • The consistent feeling that something bad will happen
  • Overthinking and imagining the worst outcome
  • Restlessness
  • Irritability
  • Decision-making problems

What is a panic attack?

Panic disorder is the kind of anxiety that causes panic attacks, which are marked by the sudden onset of symptoms like:

  • A racing heart
  • Difficulty breathing
  • Sweating
  • Dizziness
  • Trembling
  • Numbness or tingling
  • Chills or hot flashes

Panic attacks happen quickly but usually go away within five to 20 minutes

Keep reading: How to Stop and Prevent an Anxiety Attack 

How to get rid of anxiety in the moment 

While we can't promise to show you how to get rid of anxiety for good, we can equip you with grounding techniques. Having these tools at the ready can help you through challenging times, so let's dig in. 

Acknowledge you are feeling anxious

Naming something can make it feel less scary. When you're having a panic attack, knowing that it is a panic attack -- and that it will pass -- can go a long way.

Similarly, if you live with GAD, knowing that what you're feeling is part of a health condition, not a reflection of how the world actually is, can help you feel more grounded. Talking to someone about what you're feeling, whether it's a friend or a doctor, can also help to provide anxiety relief. 

Practice breathing exercises 

Breathing is one of the most powerful calming tools. Between the added oxygen and the stimulation for your parasympathetic nervous system, breathing can work wonders. Plus, breathing techniques are free and you can do them anywhere. 

As you learn how to deal with anxiety, it can be helpful to memorize some breathing exercises you can do anytime, anywhere. Slow, diaphragmatic breathing is a great place to start. Putting your hands on your stomach can help you learn this skill, but you don't necessarily need to do that if you're in public. 

Read more: 5 Easy Breathing Exercises to Relieve Stress and Relax 

Woman concentrating on breathing exercises at home

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Try the 5-4-3-2-1 method while anxious

Grounding yourself makes a big difference when you're feeling anxious. To do that, you can use the 5-4-3-2-1 method:

  • Look around and spot five individual things.
  • Touch four things near you. 
  • Acknowledge three things you can hear. 
  • Identify two smells.
  • Check in with your mouth for one thing you can taste.

By tapping into your senses, you're bringing yourself back to the present moment and anchoring yourself there. Don't be afraid to walk around to get all 5-4-3-2-1 things named. Take your time and use this as a way to help yourself relax.

Distract yourself 

It's easier said than done, but distraction can be a useful tool. Try to reposition your mind from a place of worry to focusing on something you enjoy. Go for a walk somewhere nice, listen to music you love, show your pet some love, get yourself a beverage to enjoy, chat with a coworker -- whatever works to distract your mind.  

Journal through situations

Studies show that journaling can help as you're learning how to calm anxiety. You could freewrite, jotting down whatever comes to your mind. Getting it out of your head and down the page can help with letting things go. Or you might try to journal about what you're grateful for since that can shift your mind to more positive thoughts. 

More tips to help

If you're still hunting for how to deal with anxiety when it affects you, we have some more calming life hacks you can try out. 

How do I know if I need treatment for my anxiety? 

Even though there's no immediate fix to get rid of anxiety once and for all, you can learn how to help anxiety when it impacts you. The tools we just laid out can build the arsenal you can turn to whenever you need anxiety relief.

Be mindful of how often you turn to that toolbox. Most of us deal with anxious feelings from time to time. If you're leaning on these tools to get you through the day on a regular basis, you may benefit from professional help.

Signs treatment may help your anxiety:

  • Your anxiety is a daily obstacle 
  • You've stopped doing things you used to enjoy because you feel anxious
  • You worry through most of every day
  • You continually feel physically unwell
  • You always assume the worst outcome
  • You experience panic attacks

Getting relief could mean talk therapy, medication or something else. But if all of this sounded familiar, know that help is waiting. Talk to your primary care provider or find a therapist in your area or online. Mental health experts are your best bet if you want to figure out how to treat anxiety that continually affects you. 

The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.

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There is no easy way to live with anxiety. You are not the only person suffering from anxiety, millions of others are looking for ways to find relief as well. Controlling anxiety requires time and effort – it is not something that can be accomplished overnight. 

Nevertheless, you can incorporate strategies for fighting anxiety into your daily routine. Those who suffer from anxiety right now, or who experience anxiety often enough to need immediate relief, may benefit from the following strategies for reducing anxiety. Visit www.healthline.com to learn more about the ways hemp can treat anxiety.

Control Your Breathing

Poor breathing habits are often linked to severe anxiety symptoms. Several of the most upsetting symptoms of anxiety are associated with poor breathing habits among men and women with anxiety. It’s not what you think – controlling your breathing is the solution. You should not try to take deeper breaths if you don’t feel able to take a deep breath. Instead, you should slow down and reduce your breathing.

Get Therapy

Talking to someone you trust and like is another very effective technique. Don’t hide your anxiety – tell them what you’re feeling and why you feel that way. Your mind is kept off your symptoms by talking to nice, empathetic people, while friends and family are supportive. A friend can also provide you with peace of mind if you’re suffering from a panic attack because if something were to go wrong, someone would be able to care for you.

Exercise

Adrenaline floods your body during times of anxiety. A great way to improve your anxiety is to use that adrenaline to do aerobic exercise. The intensity of your anxiety symptoms, as well as the nature of your anxiety, can be significantly reduced with aerobic activity, such as light jogging or even fast walking.

Find A Way To Relax

Your life is already filled with relaxing things. Consider making a list of the things that you enjoy and that help you relax so that you can refer to it when you feel anxious. To stop anxiety symptoms before they escalate, turn to those activities when you notice your anxiety rising. Consider taking a warm bath if you find it relaxing. It’s easy to relax when you’re in the tub, lighting a few candles or adding some soothing scents. Getting a massage or bathing, skipping stones at the park, or taking a bath can all help relieve anxiety sooner rather than later. Click here to learn more tips for relaxing.

Your mood and anxiety can be greatly affected by music. There is, however, more to selecting songs than just liking them. Listen to music that reflects what you want to feel, but also makes sure it represents what you want to accomplish. The way you feel and the mood you are in can be directly affected by music that is happy or relaxing.

Despite the fact that people often find it relaxing to listen to angry music during times of anger or sad music during times of sadness, such music will only serve to intensify negative emotions. You won’t feel better if you do that. Listening to music helps you calm down when you’re trying to stop anxiety.

Consider Medicinal Cannabis

Some sufferers look for more natural alternatives to prescription anxiety medications because they’re frustrated with side effects. These alternatives don’t cause them to feel unwell, sap their energy, or flatten out their emotions. 

Medicinal marijuana for anxiety can offer relief with manageable or even nonexistent side effects for some patients. Cannabis oil can be vaporized, taken orally or through a sublingual spray, and edible treats can also be consumed to consume it; it doesn’t necessarily have to be smoked.

Cannabis may reduce panic attacks and treat generalized anxiety disorder in those who benefit from it. People suffering from social anxiety may benefit from it since it enables them to leave their houses and interact with others on a daily basis. 

As a result of chronic pain or cancer, marijuana can also reduce secondary anxiety. Performance-related anxiety is said to be eliminated by working out while high for many athletes. You can get this resource from hifi farms to help with anxiety symptoms.

Try Essential Oils

Many conditions, including anxiety, have been treated with essential oils, which are extracts from plants. Serotonin, a feel-good chemical released by essential oils, is activated in certain brain areas by essential oils. Anxiety, stress, and depression symptoms are eased, mood is improved, and sleep quality is enhanced with their use.

Anxiety symptoms can be alleviated through diffuser use, inhalation, or topical application. Using an essential oil diffuser will allow you to fill your space with the desired scent when diffusing an essential oil or essential oil blend (mixed oils). 

Essential oils are inhaled by deeply inhaling them straight from the bottle or through the use of a diffuser pad (sometimes leather or felt) or lava beads attached to a bracelet, necklace, or keychain. Drops of essential oil can also be placed in your hands, rubbed together, and then cupped and inhaled deeply.

It is also possible to apply essential oils directly to the skin in areas such as behind your ears, the back of the neck, the wrists, over your heart, over your carotid artery, and over your heart. A healthy adult’s recommended dilution level is 2%, which means mixing one teaspoon of a carrier oil with two drops of an essential oil. (Examples of carrier oils include olive oil, grapeseed oil, almond oil, jojoba oil, or avocado oil.) All essential oils should be diluted, but individuals decide how much and if they wish to do so. In addition, it is strongly recommended that young children, babies, the elderly, and those who are unhealthy use stronger dilutions.

Control Your Thoughts

There is no such thing as an anxiety attack out of nowhere. A common reason why people experience anxiety attacks is because their minds spiral into negative thoughts. When you learn to dismiss triggers that cause anxiety and keep these thoughts at bay, you can sometimes control this anxiety. Many people find it difficult to follow through on this. However, you can try a number of different strategies that may be effective.

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On September 10, the globe commemorates World Suicide Prevention Day (WSPD). As the name implies, the day is dedicated to raising awareness about suicide prevention all across the world. World Suicide Prevention Day (WSPD) was created in 2003 by the International Association for Suicide Prevention in collaboration with the World Health Organization (WHO). Suicide deaths account for 1.4% of all fatalities globally. The majority of suicides are caused by mental illnesses such as depression, anxiety, substance abuse disorders, psychosis, and other trauma-related disorders.

According to the National Institute of Mental Health (NIMH), anxiety is a natural component of life. However, for persons suffering from an anxiety illness, it begins to interfere with daily tasks such as job performance, academics, and relationships. Anxiety disorders are classified into different kinds, including generalized anxiety disorder, panic disorder, social anxiety disorder, and phobia-related disorders. Here are some coping strategies for anxiety and depression:

Communicate;
Share your emotions with whomever you trust. Allowing your feelings to be expressed to a trusted friend, companion, or family member will help you feel calmer on the inside and provide you with clarity of thinking. Holding down emotions can lead to increased mental tension and overthinking.

Self-care;
If you are feeling worried, take a break from whatever you are doing to relax. When you are overwhelmed with worried thoughts, do breathing techniques and drink water. This will assist you in allowing your energy to settle. Go for a walk in the fresh air to clear your head. Incorporating yoga and meditation into your daily routine might also help you deal with anxiety.

Engage in physical activity;
Being physically active and healthy will assist you to direct your energy in the proper way, allowing you to cope with your worried thoughts.

Dietary Supplements;
A well-balanced diet may do wonders for both your physical and emotional well-being. The necessary minerals, vitamins, and other ingredients will guarantee that your brain functions properly, allowing you to deal with stress more effectively.

Seek Professional Advice;
Seek quick professional treatment if your anxiety is interfering with your everyday life. Professional assistance can help you overcome your problems by utilising available therapies and drugs (if necessary).

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