In This Chapter
Mindfulness is a lifestyle rather than a short-term fix, and my hope is that this book provides you with the tools you need to get started with mindfulness and manage your anxiety a little better.
But anxiety is a complex condition that can appear in many different ways. You need to determine whether your level of anxiety requires you to see a medical professional or not. From time to time, everyone has some of the anxiety symptoms that I mention in this book – in many ways, they're what give people their little quirks and make them human! But as I discuss in this chapter, if you have several of those symptoms, they're at a disturbing or excessive level and are severely affecting your work and home life, you need to seek medical help.
This chapter is also about developing your mindfulness practice further, whether that's reading more on the topic, engaging in an eight-week mindfulness course or going on a retreat. In addition, I mention other therapies and organisations that are very beneficial for anxiety sufferers.
You may just have mild anxiety occasionally and find that using self-help books and moving your focus onto other things helps you manage it. You may also have gone through a stressful event recently that caused anxiety, such as a divorce, starting a new job or place of study. Or you may have suffered the loss of a loved one or moved to a new area where you don't know anyone.
Anxiety developing in these life situations is very common. The anxiety may be short term and eventually fade away. This book is designed to help with such mild to moderate anxiety.
But some anxiety is more serious. This section describes the symptoms of severe anxiety to help you decide whether you need to seek medical attention.
If you think that you have a more severe form of anxiety, consult your GP before undertaking any kind of self-help.
Severe anxiety usually lasts for a period of six months or more. In that time, you're likely to have experienced symptoms such as chronic worrying every single day. If you have had this type of anxiety for that amount of time, visit your GP who'll want to know how you're feeling and probably ask about your home, life and work situations.
Even though talking to someone about your feelings and emotions isn't easy when you have severe anxiety, the more information you give, the better the doctor can help you and decide what treatment is best going forward. Your GP may also do some tests to check whether any other health problems exist that can also contribute similar symptoms, such as anaemia.
Severe anxiety can feel overwhelming and hard to handle. It may manifest itself in uncontrollable worrying in which the worries are extremely upsetting and stressful.
Here are four common anxiety conditions and their symptoms, which can all be at a difficult level to deal with:
You may also have some of or all the physical symptoms that go along with anxiety, such as a fast heartbeat, an urge to use the toilet more often, a dry mouth and sweating.
If you recognise any of these symptoms and they're at an excessive level, the time has come to see a doctor. They can determine whether these symptoms are due to anxiety or some other cause. They can also make a more precise diagnosis and determine the right course of action for you – which may or may not be mindfulness-based.
Severe anxiety can affect your life in many different ways and impact on your relationships, home life and work.
Check out the following behaviours that can occur in people with severe anxiety:
Anxiety can also make you needy and dependent. You may start to fear being left alone and not like your partner going out without you. You may also become very tearful.
The eight-week mindfulness course or Mindfulness Based Stress Reduction (MBSR) was started in 1979 by Jon Kabat-Zinn at the University of Massachusetts medical school. It has been running for over 30 years and is used in a secular way in hospitals, schools, prisons and workplaces.
Research shows that an eight-week mindfulness course can create the following benefits:
You can pursue the eight-week mindfulness course in many different ways, but every approach requires a certain level of commitment. You need to be able to do the following:
Mindfulness isn't like developing other skills. If you start to learn a martial art, how to cook or any new skill, and you get bored, you can just give up. But mindfulness works differently; it's about sitting with those feelings of boredom and accepting them rather than giving up. In fact, mindfulness encourages you to bring attitudes of curiosity and acceptance to your boredom instead of quitting at the first hurdle.
Also, mindfulness has no specific goals and is about being rather than doing. If you're learning a martial art, with enough practice, you can eventually be a black belt or equivalent. But with mindfulness, your experience is different every time, and no right or wrong way exists on how to meditate. The only achievement you have to make in the eight-week course is to ensure that you do the practices!
Mindfulness also involves learning about yourself rather than about external things. You discover how to watch your thoughts, experiences, feelings and emotions. In many ways, the concept is completely different from what you may be used to, so it can feel challenging at first. But the rewards outweigh that.
The eight-week course may not be suitable if you've just been diagnosed with bipolar, post-traumatic stress disorder or have severe anxiety, such as I mention in the earlier ‘Determining Whether Your Anxiety Needs Medical Attention’ section. Always check with a GP or health professional before starting.
Lots of support and resources are available if you want to practise the eight-week mindfulness course by yourself. The benefits of doing so are that you don't have to stick to any set times and can practise whenever and wherever you feel like it, in a comfortable setting such as your own home.
Motivation is a little harder when practising on your own, however, because you don't have anyone else except yourself to push you or rely upon. Therefore, I outline here some great resources in the form of audio and books to help you get started:
Dr Kabat-Zinn wrote this book based on his MBSR course, and it provides a detailed eight-week practice schedule along with success stories and research findings. It also details how mindfulness can help with a wide range of problems from stress and anxiety to dealing with time pressures.
Their book is full of practical, simple and powerful practices, which can help break the cycle of anxiety, stress, unhappiness and exhaustion.
The book includes an eight-week mindfulness course and sections on mindful parenting and mindfulness for children, as well as mindfulness for stress, depression and anxiety.
The book explains the body's fear system and how anxiety arises. It offers healing mindfulness practices in a step-by-step format with testimonials and explanations.
Mindfulness is increasingly common, so mindfulness courses have become widely available. Finding a course near you means that you can mix with like-minded people and have the support and motivation to keep going and stay focused.
Here are several ways to find a course near you:
A range of mindfulness coaching is available online or in person. Coaching can help you if you're struggling to meditate by yourself or having difficulty getting motivated.
A coach can guide you through an eight-week mindfulness course and give you support and help along the way. If you're struggling or even just have concerns or worries, a coach can help you overcome them and continue focusing on your mindfulness practice. Have a search online for mindfulness coaches in your area.
I offer mindfulness coaching online and in person. Visit www.joellemarshall.com for more information.
Mindfulness can work well alongside many different therapies and medication. It can help you manage your medication and boost other forms of therapy.
Anxiety often has a number of related conditions, such as adult Attention Deficit Hyperactivity Disorder (ADHD), chronic pain, fibromyalgia and Body Dysmorphic Disorder (BDD). You may find that knowing how mindfulness can work with therapy for some of these conditions is very useful.
In fact, therapists themselves are recommended to practise mindfulness because they can cultivate self-compassion, experience less burnout and thus have a better connection with their patients.
Mindfulness can work alongside therapy to help with a variety of conditions and create helpful programmes. You may be able to find these programmes in your local area through a simple search online, or you may even want to do an online course. For the UK, you could search bemindful.co.uk for example. Alternatively, your doctor or health professional may have specific recommendations for you. Here are some examples:
Using ACT for anxiety
Research shows that Acceptance and Commitment Therapy (ACT) helps to treat anxiety along with numerous other mental-health conditions. It works by trying to stop controlling your anxious thoughts and feelings (acceptance), living in the present moment (mindfulness) and then preparing a course of action for moving on alongside your core values.
The idea behind ACT is that when you allow yourself to accept your anxious thoughts and feelings, you can then focus on the present moment and start to take steps to live how you want to.
The research results for ACT are very promising. It's definitely worth trying.
Therapies that work for some people may not work for others because everyone has slightly varying anxiety conditions. A combination of therapies may work for you, or a combination of therapy and medication, or just medication or just therapy. Always consult your doctor.
Cognitive behavioural therapy (CBT) is the most common therapy for anxiety. It features a combination of two elements:
The therapist may gently guide you to face up to your fear and expose yourself to the place or thing that makes you anxious. You discover techniques on how to handle your anxiety, by gradually engaging in the activity that causes you anxiety, step by step.
These two techniques work in combination because how you behave is usually determined by how you think. Depending on your condition, the focus is more on the cognitive or the behavioural element.
CBT contains many advantages:
CBT is different from mindfulness because it's about changing thoughts to change behaviour. In contrast, mindfulness is about identifying thoughts that arise in the present moment, seeing them as separate from you and being as nonjudgemental as possible toward them.
Although they are two very different techniques and approaches, Mark Williams, Zindel Segal and John Teasdale combined mindfulness and CBT to create Mindfulness Based Cognitive Therapy (MBCT). It's based on Jon Kabat-Zinn's MBSR programme (see the earlier section ‘Engaging in an Eight-Week Mindfulness Course’):
Although MBCT was specifically created for people with depression, it's also been scientifically proven to help with other disorders. The benefits of MBCT on people with anxiety are
The intention is that participants come to see their thoughts as mental events that arise with and are fueled by anxiety or depressed mood, but do not have to be taken personally. They no longer relate from their thoughts but to their thoughts as objects of awareness.
To find out more about CBT and MBCT, take a look at the following resources:
Also take a look at www.mbct.com, which is written by the developers of MBCT. It includes a clear explanation of the program and where to find a suitable therapist.
Some people overuse medication for anxiety or use it as an avoidance tactic. They may take medication every time they have to face an anxious situation, such as meeting a new person, leading a work presentation or getting through a difficult family situation. But this behaviour doesn't help long term because you're essentially avoiding the feeling of anxiety. A fear of anxiety is what continues to feed the anxiety in the first place. Ultimately, mindfulness is about discovering how to accept and make space within you for the feeling of anxiety rather than trying to constantly fight it.
Mindfulness allows you to manage your anxiety more effectively in such events. It's about becoming aware of your thoughts, stepping back from them and seeing anxiety as part of your experience rather than part of you. You can then regain control over your life and lose the reliance on having to self-medicate.
Using mindfulness to manage everyday stressful events means that you don't have to overuse your anxiety medication, but instead just use it as prescribed by your doctor or health professional. In some cases, mindfulness has proved to be better than medication at curing conditions such as insomnia.
Mindfulness can work well alongside prescribed medication and can help you if you decide in the future to reduce your medication slowly, too.
Always talk to your doctor if you're thinking about reducing or coming off prescribed medication. Coming off medications needs to be done slowly and gradually with a lot of help, advice and support; going cold turkey may cause side effects. Always make sure that you consult with your doctor before changing anything about your prescribed treatments.
If you really want to deepen your experience of mindfulness, consider going on a mindfulness retreat. This section offers advice on how to make a choice about whether you should go on a retreat, and which one is right for you, at this time.
The section also includes lots of great organisations that can support you through your experience of anxiety.
Retreats are a great way of engaging in mindfulness without the distractions of home and work life. You can fully focus with like-minded people, often in beautiful settings and locations.
Here are some benefits of a retreat:
A lot of really great mindfulness retreats are available to you:
A retreat may not be for you at this point if you're suffering from severe anxiety and emotional distress, or have just been diagnosed with a mental-health condition such as clinical depression or post-traumatic stress disorder. You may need one-to-one support before experiencing a retreat. Consult your doctor or health professional before booking.
Many great organisations can give you round the clock support and advice, however you're feeling. If you want to discover more about your condition, you need someone to talk to or you want to research how different therapies can benefit you, all these organisations can help:
The Samaritans are listening. …
When you call the Samaritans, a volunteer answers your call. The person listens to you when you talk about how you're feeling. You may then be asked whether you're feeling suicidal and about other feelings you may be having. You can talk for as long as you want to and end the call when you feel ready.
You can contact the Samaritans as follows: