by Dr. Gary McClain, PhD

Published: Lifelines for Health Fall 2018

Living with a chronic condition gives you all kinds of reasons to feel anxious. Do I need to go through a list with you? Probably not. Humans don’t do well with uncertainty. And chronic conditions can bring all kinds of uncertainty to your life. Having to face a test or a procedure. Adjusting to changes in your daily life. Thinking about the future. And stress. All of this can lead to anxious feelings. So, what do you do about those anxious feelings? Suffer until they hopefully go away on their own? Try a technique and hope it works? You’ve got more options than that. Coping with anxiety begins with how you think about anxious feelings as well as preparing yourself for the anxiety that might come your way.

Here’s how to get started: Accept that anxiety is part of life

When I was in training to be a therapist, one of my teachers said this at the beginning of a lecture on working with anxious clients: “You’re anxious. So what!” Look around you at the world news, your community, your family and friends. You could say that any given day brings lots of reasons for anyone to feel anxious. That doesn’t mean you have no choice but to be continuously overwhelmed with anxiety. Not at all. The point is that unless you’re comatose, you’re probably going to experience some anxious feeling from time to time, or often. It’s normal, and you’re not alone.

Lean in to your anxiety

Here’s a mindfulness exercise for you. Visualize yourself hiding in your house with all the doors and windows locked and anxiety standing outside on the porch, pounding on the door to get in. And then, imagine opening the door and saying: “Come on in, anxiety. Let’s sit down and talk.” If the anxiety is not going away on its own, you might as well see if the two of you can come to an understanding.

Look for the lesson

Is there something you can learn from those anxious feelings? In other words, could some of that anxiety be a message from your mind that it’s time to take better care of yourself or to make a change for the better in your life? Successful people often talk about how they use their anxiety to motivate themselves to work a little harder to be excellent. Clients living with chronic conditions often tell me that feeling a little bit anxious helps motivate them to stay compliant with their treatment and self-care routine. This isn’t to say that’s all that anxiety is good for you. But if there’s lesson there, then learning it might help you to reduce some of that anxiety.

Don’t get anxious about getting anxious

Nobody likes being anxious. But I often find with my clients is that they dislike anxiety so much and are so afraid of being overwhelmed by their anxious feelings, that when they feel anxiety coming on, or worry that they might get anxious later, they get anxious about the anxiety. They do this by worrying about how bad their anxiety might be. They create anxious stories about what might happen.

They get anxious about how they’re going to cope with the anxiety. And guess what? They end up creating more anxiety for themselves. Watch out for negative self-talk that helps to create more anxiety.

Talk to yourself

When anxious thoughts and feelings start building up in your mind, talk yourself off the ceiling. Remind yourself that it’s normal to be anxious sometimes. Ask yourself what you can do for yourself to reduce your anxious feelings. When your mind tosses those scary stories and images at you, talk back to them: “Bad things can happen but so can good things. I can’t predict the future.” When you stop fighting anxiety, you free yourself up to focus your energy on what you can do about it.

Calm yourself down

Think about what helps you when you’re feeling anxious. Imagining a relaxing place like the beach? Taking a walk? Listening to music? Reading a book? It might help to put a tool kit together with the calming techniques that work for you, and have them ready for when you feel anxious.

Be proactive

Take a look at recent days when you have felt less anxious to find clues for how to avoid anxiety. Was there something you did or didn’t do that day that might have helped you to have a more relaxed outlook? Were you compliant with medication? Following your diet? Staying active? In touch with supportive people? One of the best ways to cope with anxiety is to not set yourself up to feel that way by building anxiety prevention into each and every day. Again, apply the lessons that anxiety can teach you. As they say, an ounce of prevention is worth a pound of cure.

Talk to somebody

Get some perspective. Sit down with someone who can listen without judging you or telling you what to do. Talk about what’s making you feel anxious. Sometimes just saying it out loud can help you to see what’s real and what’s being manufactured by your imagination. Ask for some encouragement. And maybe some accountability if you want to make some changes for the better.

And reach out for help if you need it

If you are feeling overwhelmed by anxiety, if it is interfering with your ability to do what you need to do
to take care of yourself, if it is getting in the way of your relationships, or if it is making it hard for you to make decisions, then it may be time to reach out to a mental health professional. Talk to your doctor if you aren’t sure where to start. Don’t go through this alone.

Anxious feelings are part of being human. Lean in to your anxiety. Listen for the lesson anxiety can teach you. And take good care of yourself.

Keep Calm

Withdraw if you need to. Move yourself out of the center of the action. Physically, mentally, or both. Step back. You can even say something like, “I need a moment.”

Use your breathing. That initial emotional rush can be overwhelming. Notice how you’re breathing. Little short breaths? Not breathing at all? Take a series of deep, calming breaths. In through your nose, out through your mouth.

Do things that calm you down. Listen to music. Take a walk. Read. Do some relaxation exercises. Anything that helps you to stay calm, that helps you feel connected to your center. Calming yourself down is essential if you are experiencing symptoms of PTSD.

Don’t fight your feelings. Okay, so you’re having a lot of feelings. The worst way to cope with emotions is by pushing them down or trying to pretend they aren’t there. Your feelings are your feelings. Good feelings, feelings you aren’t so proud of. Give yourself permission to feel them all.

Remember that feelings may not represent reality. The feelings of the moment can make the world around you look pretty foggy. You may see things that aren’t real, like what someone else’s motives look like, or where a situation seems to be going. All the more reason to take a pause until the fog dissipates.

Try to be patient with yourself. Emotions are part of being human. Our way of coping with strong emotions is hard wired into us, based on years of practice. Some of us shut down, some of us wear our emotions on our sleeve. Learning how to cope with emotions in a healthier manner takes practice. And keep in mind, if you’re living with a chronic condition, you have that much more on your plate. So be patient with yourself.

Most of All, Stay Supported...

If you’re living with a bleeding disorder and an inhibitor, you already know the value of staying connected to your support network. If you are experiencing strong emotions, and especially if you suspect you are experiencing PTSD, it is important to get emotional support, professional support, family support, friends, and other members of the inhibitor community. The same if you are a caregiver. If you are a family member of someone you suspect may be experiencing PTSD, it’s important to get support for both your loved one and for yourself. Don’t go through this alone!

You, your chronic condition, and your mental health. You’re dealing with a lot. And one stressful situation followed by another can take a big toll on your mental health. If it’s all starting to wear you down, do the bravest thing in the world and ask for HELP. PTSD, like other mental health conditions, is treatable.