Reflections and guidance on anxiety, depression and low self-esteem

In this article, I will outline some understandings of and strategies to address anxiety, in the hope that this will help you. Following articles, will address depression and low self-esteem, please look out for these. The main way that you can help yourself is through good self-care, based on establishing a routine in your life of regular sleep, food, fluids, exercise and relationships.

Firstly, the origins of anxiety stem from the Latin substantive angor with the related verb ango, which means to constrict. Anxiety perhaps describes feelings of worry, tension or fear – especially regarding the future, events in the future, or which we consider could happen in the future. Interestingly, the similar relationship between the idea of restriction and anxiety is evidenced in Biblical Hebrew too. In the Bible, Job articulates his anguish (Job 7:10) through the Hebrew expression, namely “the narrowness (tsar) of my spirit”.

Anxiety is a necessary feeling helping to signal danger and is a natural human response when feeling under potential or actual threat. Regarding Generalised Anxiety Disorder, this involves excessive worry about a number of events over at least 6 months, where individuals find it hard to manage their worry. People who worry can justify worrying but it is mainly considered a safety behaviour and it may be helpful to think what would I be doing or thinking if I wasn’t worrying. Worrying can be falsely thought of as helpful but rationally it can often be communicated a s form of concern but imposes on others and perhaps oneself in a harmful way. Generalised Anxiety Disorder can be thought of in terms of a difficulty with tolerating uncertainty, namely about the future. A way forward is to think of managing events as interesting experiments to get to know oneself better and to learn from how in fact you do manage, rather than relying on worrying thoughts which can repeat and repeat in the mind, which isn’t helpful but rather takes your time and life away from living your life. Perhaps, when find in yourself ruminating or procrastinating, try to bring yourself into the present through for example focusing on your breath or splashing water on your face to change your emotional and physiological body temperature.

Which other strategies may help you when feeling anxious? Another intervention for self-care is what is known as the ‘333 rule’ to assist anxious feelings, which is perhaps an easy method to remember and to use in the event of a situation triggering your anxiety. The ‘33s rule’ invites you to look around you in your environment and identify three items, and then three sounds, then moving three body parts, recognising three thoughts, feelings and physical sensations. It can be very helpful to write these down. Journaling (writing your thoughts and feelings in a book) is recognised as an excellent way to process thoughts and feelings which are then objectified on paper and can be reflected on and considered, in order to move forward to make more informed decisions based on increased self-awareness.  If we think about different degrees of anxiety, perhaps influenced by personality and the extent to which we interpret events and feel the impact of them. Other influences may be the extent of coping strategies, life experiences, race and gender. The extent of anxiety felt is categorised by the extent of distress and restriction experienced. There are four main categories: mild, moderate, severe and panic classifications of anxiety.

It can be very debilitating and overwhelming to experience higher levels of anxiety, but there are many ways in which you can help yourself by learning a range of strategies and testing out what best works for you. A main focus is to bring yourself int the present, whether by holding ice, splashing your face with cold water, walking, tapping your skin, including acknowledging five items that you see around you, moving the focus externally and away from your internal state of worry or anxious feelings. Then, look for four items that you can touch in your vicinity; three sounds that you can hear; two smells; and one identified taste.

Another intervention which you can do yourself is following the thoughts as a potential step forward to interrupt the anxiety cycle, which had been keeping the anxiety going. Gradual exposure t0 the feared situation will help you learn that the situation is feared through false belief rather than in actuality. The more that you do the feared action such as going to the shops or reading in public, the more that you learn that it doesn’t need to be feared; the actual experience is much easier than you had thought. This leads to increased confidence and a can-do attitude and enhanced motivation, inspiration and sense of fulfilment, self-worth and achievement. The result is reduced anxiety, broader activity that you feel you can engage with and a better quality of life, including aspects that are most important to you.

Alternatively, anxiety can be described as an uneasy feeling, such as worry or fear, which can range in severity, due to a plethora of reasons. As mentioned earlier, everyone presumably experiences anxiety through their life. For example, you may feel worried and anxious about a dental appointment, driving test, interview or meeting with someone influential to your future. It would be perhaps surprising if one didn’t feel some anxiety in these circumstances. However, there are individuals who struggle to manage work, and such anxious feelings can be persistent and interfere with daily living. It is known considered that anxiety is a main symptom underpinning a number of conditions, namely: social anxiety including social phobias, post-traumatic stress disorder (PTSD); phobias, for example claustrophobia and agoraphobia, and panic disorder. 

Anxiety which is hard to manage, severe and persistent, as mentioned earlier, is described in DSM V as generalised anxiety disorder (GAD). This can be a long-term condition, where anxiety is felt in relation to a wide range of situations and circumstances rather than one issue. Individuals with GAD report feeling anxious on most days and often cannot recall the last time when they were relaxed. Worrying can become a way of life, such that when one worrying thought appears resolved, another appears to take its place. One can surmise that the worrying serves a function, usually referred to as a safety behaviour, which would need to be dropped to progress, grow and develop in your life.

It is worthwhile being aware that GAD can exacerbate both physical and psychological impairments, which vary from one individual to another but mainly include: experiencing restlessness or worry; problems with concentration or with sleep; palpitations or light-headedness.

Holistic talking therapies, which take into account your past and present situation, with signposting to strategies to help reduce anxiety and improve self-care, can be of most help. It an also be helpful to discuss the possible causes of GAD for you, such as: genetic inheritance, past traumatic experiences, long-term health conditions, family dynamics, or substance misuse. However, some people may develop GAD for no apparent reason.

I am trained to help individuals with anxiety and have proved success in this field, drawing on multiple therapeutic approaches. If you feel that you need help, you are welcome to contact me for a confidential, friendly and professional free 15-minute introductory consultation, when we can discuss what you need and you can decide if you want to arrange an initial session in person, online or by phone, or not. We can take it from there and see how it goes, looking forward. I will do my utmost to help you; I offer a sliding scale of fees to accommodate the widest population, interested to work with people from a diversity of backgrounds and cultures, and the most vulnerable in our communities.

You can contact me by phone on 07952 717 951, by email helen.holmes2023@outlook.com, or through my website www.helenholmespsychotherapist.com I look forward to the possibility of hearing from you. Take care.