Anxiety is a common experience for people with BPD. We are also naturally in anxious times, with routines disrupted and danger being projected around every corner, it'll be heightened further. Fear, worry and anxiety have strong survival uses, serving to get us through threatening situations. It gives us an awareness of danger so that our flight/fight response can kick in. Whilst anxiety has it's place, when it is affecting you for long periods of time, to the wrong extent or in the wrong place - it is unhealthy. With this is mind, today we will look at how anxiety presents, why and a few coping skills to use.
We may notice that we are experiencing anxiety, we have intrusive, fixated, racing thoughts. Our eyes will dilate to take more visual information about the percieved danger . You might experience a dry mouth or nausea. You may breathe faster to get ready to fight or run causing sweats or your heart racing. Your stomach may churning or you may experience an 'anxious bladder'. These symptoms may escalate into a panic attack (averagely peaking at 10 minutes, ending by 30 minutes). In short: we are on 'red alert', both mentally and physically.
A way of understanding what is happening inside is to compare the different sections of our brain to a company. The Prefrontal Cortex is the CEO, it makes logical decisions, preforms risk assessments and listens to feedback from the rest of the brain. The Amygdala is the chief security officer, it protects and recognises threats. This is the section of the brain that goes haywire during stress. The Hippocampus is the secretary, it stores all of our memory.
When we get stressed, the amygdala perceives a threat it starts redirecting both energy and blood away from the prefrontal cortex, using it to power our fight and flight response. This is why our centre of logic tends to 'shut down' when experiencing too much stress. Deep breathing increases the blood flow around the brain, back to the prefrontal cortex, to get the logic centre back online. The amygdala also begins ordering the production of the fear hormone, cortisol, causing all physical symptoms, as a protective measure. Cortisol can temporarily shrink the Hippocampus, this means that during anxiety, we might forgot things or experience our minds going blank. We can't remember concepts such as 'I've done this before, I can do it again'. This also means that whilst we're experiencing severe stress, the Hippocampus can throw out memories as they occur, causing traumatic amnesia, or storing the experience elsewhere in the body (e.g. causing IBS).
It is natural to respond to anxiety with avoidance as it can provide short-term relief. However, in the long time it can worsen as we don't learn how to cope and move past anxiety.
It is important to 'get to know' your anxiety. Knowing your potential triggers and what anxiety personally looks like to you can help you interrupt the process, instead of feeling controlled by it. Although it may be tempting to ignore the way that you feel, it is important to understand your emotion so that it doesn't feel the need to escalate in order to force your acknowledgement. All emotions need to be heard. This can be done when you are in a 'good space' after experiencing anxiety if you're not able to touch base at the time - reflect back: what happened there for you? What is your anxiety trying to protect you from?
So what can we do?
There are problem-solving coping skills if your anxiety is caused by a situation within your control, for example: Time management, working out what I can and I what can't achieve or talking to somebody who has the power to change the situation. To put this into action: if my anxiety is because I am behind on paying my council tax - it'd be a good idea to ring up the council and ask for help or a payment plan.
For situations outside of my control, emotion-focused coping. These reduce internal stress when dealing with difficulties outside of my control, for example: Seeking social support, grounding techniques, self-soothing writing, seeking out professional help.
As all of us are individual, different techniques will work for different people for different situations. Having an array of coping skills to work in different circumstances is also useful; in the same way you wouldn't use a hammer to fix a window pane - but you would on a door frame, you might not use the same coping skill for every situation. Practising coping skills on lower-level anxiety will help 'strengthen' them for the higher-level anxiety when you need them.
Below are a series of sheets on coping skills that you might find useful to begin exploring what works for you.
References or further reading:
This blog post is amended from a vlog from our group facilitator, Amy, which can be found here: https://www.facebook.com/296151727080613/videos/261860988165258/
https://www.therapistaid.com/therapy-worksheets/anxiety/none
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