Deep brain stimulation (DBS)
In this procedure, an electrical stimulator is surgically implanted in the chest with leads going deep into the brain. This treatment was first used to help those with Parkinson's disease, a progressive neurological disorder that effects movement. People with Parkinson's noticed an improvement in their moods when DBS was started.
Now, the FDA has approved DBS to be used with very severe, treatment-resistant OCD (see Chapter 2). This innovative treatment appears to have helped some with severe, chronic OCD.
The side effects of DBS can include bleeding of the brain, movement problems, and delirium. At this time, the treatment should only be considered in extreme cases.
Transcranial magnetic stimulation (TMS)
TMS involves inducing a magnetic field on the scalp by sending an electrical current into a coil. This treatment does not require surgical implantation, so side effects are less dangerous than those treatments that involve surgery. However, research on the successful use of this technique for those with anxiety disorders is quite sparse.
TMS has mainly been used to treat depression. Studies on TMS have been somewhat inconsistent. Because studies have varied in the strength of the magnetic field, the placement of the coil, and the duration of the treatment, it is hard to compare and contrast the results. Many more studies are needed to recommend TMS for helping people with anxiety.
Part III
Letting Go of the Battle
In this part . . .
You see how to deal with anxiety more indirectly with a calm, passive approach. We show you how connections with other people, relaxation exercises, breathing techniques, good sleep habits, and proper nutrition all help quell anxious feelings.
You also discover why taking a mindful approach to anxiety is emerging as an exciting, empirically validated way to overcome anxiety. Mindfulness helps you accept the inevitable uncertainty and risk in life with calm detachment.
Chapter 10: Looking at Lifestyle
In This Chapter
Discovering what's really important to you
Working out anxiety's kinks
Sleeping away anxiety
Creating a calming diet
Do you lead a busy life with too much to do and too little time? Do you grab dinner from the nearest drive-through for you and the kids on the way home from soccer practice? Do you lie awake at night thinking about everything you have to do? Your frantic lifestyle probably leads to poor sleep, not enough exercise, and poor diet. You know you should be taking better care of yourself, which makes you feel stressed and anxious, compounding the problem.
In this chapter, we describe three sound strategies for calming down your life: staying connected with others, delegating, and saying "no." We also help you find the motivation for bringing exercise into your life. We show you how to get the best rest possible and what to do in the hours before bed that can help your sleep. Finally, we take a look at some tips for improving eating habits to quell anxious feelings.
Friends and Family — Can't Live with 'em, Can't Live without 'em
Some days, the people in your life provide all the love and support you could ever want. They offer to do things for you, listen to your woes, and comfort you when things go wrong. Other days, those same people make you wish you could move to a deserted island for a couple of weeks. They make unreasonable demands and lean on you excessively — complaining about problems of their own making, leaving you feeling stressed and worn out. The following three sections discuss the pros and cons of people in your life and offer suggestions on how to get the most out of your relationships.
Staying connected to others
In spite of the potential of family and friends to cause stress and aggravation, numerous studies have demonstrated that good, close relationships greatly enhance people's sense of well-being. Staying connected with people pays off in terms of substantially improved mental and physical health. Connections even appear to provide some protection against mental declines that often accompany old age.
So we highly recommend that you focus on friendship, community, and family bonds. Here are a few ideas for doing so:
Make sure you make face-to-face contact with your friends — don't just e-mail and text them.
Have family meals together whenever possible — it doesn't have to be any fancier than ordering pizza.
Volunteer at a nearby Humane Society, hospital, or school.
Call a friend you haven't talked with in a while.
Take walks in your neighborhood and introduce yourself to people you encounter.
Offer to help your family members with a garage sale or some other project.
You get the idea. Staying connected doesn't have to take lots of time or cost money, but it does take effort. That effort pays off not only for you but also for your friends, family, and community.
People with social anxiety may find these activities difficult. If that's the case for you, work on your social anxiety first as described in Chapters 5 through 9.
One connection involves you and at least one other person. So when you reach out to someone else, you may be doing them just as much good as you're doing yourself.
What's that? You say you don't have time to connect with friends and family members? We've got solutions for that problem in the next two sections.
Delegating for extra time
Many people with anxiety feel they must always take responsibility for their job, the care of their family, and their home. Unless they have a hand in everything, they worry that things may not get done. And if someone else takes over a task, they fear that the result will fall short of their standards.
However, if life has become overwhelming and too stressed, learning to delegate may be your only choice. Pushing yourself too hard can put you at risk for illness, bad moods, and increased anxiety. And delegating a few things usually works out much better than you think it will.
Here are a few possibilities for your delegating list:
Take the risk of letting your partner do some laundry and cooking.
Hire a cleaning service to come in once a month (more often if you can afford it).
Spend a Sunday afternoon preparing large quantities of a few meals that can be frozen and consumed over the next week and much later.
Enlist the family to spend one hour a week in a frantic, joint cleaning effort.
Hire a monthly lawn service.
Use online banking and bill paying — it saves more time than you think!
Read Organizing For Dummies by Eileen Roth and Elizabeth Miles (Wiley).
We realize a few of these ideas cost money. Not always as much as you may think, but still, they do cost something. Partly, it's a matter of how high money stacks up on your priority list. Balance money against time for the things that you value.
Nevertheless, not all families can consider such options. You may notice that not all these options entail financial burden. Get creative. Ask your friends, co-workers, and family for ideas on how to delegate. It could change your life.
Come up with two tasks that you could delegate to someone else. They don't need to cost money — just relieve one or more of your burdens in a way that saves you time.
Just saying "no"
We have one more idea. Say "no." If you're anxious, you may have trouble standing up for your rights. Anxiety often prevents people from expressing their feelings and needs. When that happens, resentment joins anxiety and leads to frustration and anger. Furthermore, if you can't say "no," other people can purposefully or inadvertently take advantage of you. You no longer own your time and your life.
First, notice the situations in which you find yourself agreeing when you don't really want to. Does it happen mostly at work, with family, with friends, or with strangers? When people ask you to do something, try the following:
Validate the person's request or desire. For example, if someone asks you if you'd mind dropping off something at the post office on your way home f
rom work, say, "I understand that it would be more convenient for you if I dropped that off." This will give you more time to consider whether you really want to do it.
After you make up your mind to say "no," look the person who's making the request in the eye. You don't need to rush your response.
Give a brief explanation, especially if it's a friend or family member. However, remember that you really don't owe anyone an explanation for turning down their request; it's merely polite. You can say that you'd like to help out, but it just isn't possible, or you can simply state that you really would rather not.
Be clear that you can't or won't do what you've been asked. It's a fundamental human right to say "no."
When you say "no" to bosses or family members, they may be temporarily unhappy with you. If you find yourself overreacting to their displeasure, it may be due to an agitating assumption or anxious schema. See Chapter 7 for more information.
Ready . . . Exorcise!
Please excuse our pun: We're not advising that you attempt to exorcise demons or perform hocus-pocus, but like a good housecleaning, exercise can clear out the cobwebs and cast out the cloudy thinking and inertia that may accompany anxiety.
Exercise reduces anxiety. The harder and longer that you go at it — whether you're swimming, jogging, walking, working in the yard or on your home, playing racquetball or tennis, or even walking up the stairs — the less anxious you'll be. Exercise instills a newfound sense of confidence while blowing away anxiety's cloud. With enough exercise, you'll feel your attitude changing from negative to positive.
Some people with anxiety get a little driven and compulsive. Don't take our advice on exercise and go overboard! Yes, the more, the better, but only to a point. If your exercise starts taking time from other important activities, you may be overdoing it.
Exercise reduces anxiety in several ways:
It helps to rid your body of the excess adrenaline that increases anxiety and arousal.
It increases your body's production of endorphins — substances that reduce pain and create a mild, natural sense of well-being.
It helps to release muscle tension and frustrations.
Of course, everyone has felt that they should exercise more. Most people realize that exercise has some sort of health benefits, but not everyone knows how extensive these benefits can be. Researchers have found that exercise decreases anxiety, bad cholesterol, blood pressure, depression, and chronic pain. It also decreases risks of various diseases, such as heart disease and some cancers. Finally, exercise improves your immune system, balance, flexibility, mental sharpness, and sense of well-being.
Wow! With such extensive positive effects on anxiety, health, and well-being, why isn't everyone exercising? Millions of people do. Unfortunately, millions do not. The reasons are both simple and complex. For the most part, people hit a brick wall when it comes to finding the motivation to exercise and especially to sustain it. They complain about not having the time and being too embarrassed, too old, too fat, and too tired to exercise. But if our list of benefits appeals to you, the next section, "Don't wait for willpower — Just do it!" may help you muster the motivation. And then, because we know what you're going to think next — "I don't have time to exercise!" — we provide a list of excuse-busting ways to fit your workout into your schedule.
Before beginning an exercise program, you should check with your doctor. This is especially true if you're over 40, overweight, or have any known health problems. Your doctor can tell you about any cautions, limitations, or restrictions that you should consider. Also, if, after brief exercise, you experience chest pain, extreme shortness of breath, nausea, or dizziness, consult your physician immediately.
Don't wait for willpower — Just do it!
Have you ever thought that you just don't have the willpower to undertake an exercise program? You may be surprised to discover that we don't believe in willpower. That's right. Willpower is merely a word, an idea; it's not real.
Your brain doesn't have a special structure that contains so-called willpower. It's not something that you have a set quantity of and that you can't do anything about. The reason people believe that they don't have willpower is merely because they don't do what they think they should. But reasons other than willpower account for the lack of effort: namely, distorted thinking and a failure to include sufficient rewards. Therefore, dealing with distorted thoughts and designing rewards works better than waiting for willpower.
Distorted thinking
Your mind may tell you things like, "I just don't have the time," "I'm too tired," "It isn't worth the effort," or, "I'll look stupid compared to the other people who are in better shape than me."
If you're waiting for motivation to come knocking at your door, you could be in for a long wait. Not many people wake up with a burst of new enthusiasm for starting an exercise program. Like the Nike commercials say, "Just do it." That's because motivation frequently follows action; if you think otherwise, you're putting the cart before the horse.
Lack of reward
Another problem that accounts for lack of motivation comes about when you fail to set up a plan for rewarding new efforts. You may believe that exercise will cost you something in terms of leisure time, rest, or more profitable work. In some ways, this is true. That's why you need to set up a plan for reinforcing your efforts.
Psychologists have known for decades that people usually do more of what they find rewarding and less of what they find unpleasant whenever they can. That fact may sound like a no-brainer to you. Nevertheless, ignoring the importance of rewards is easy when trying to get started on an exercise program.
Set up your own personal reward system for exercising. For example, give yourself ten points for each time that you exercise for 30 minutes or more. After you accumulate 100 points, indulge yourself with a treat — buying a new outfit, going out for dinner at a nice restaurant, planning a special weekend, or setting aside a whole day to spend on your favorite hobby. Over time, as exercise becomes a little more pleasant (which it will!), up the ante — require 200 points before you treat yourself.
Eventually, you'll find that exercise becomes rewarding in its own right, and you won't need to reward yourself as a means of instilling the necessary motivation. As the pain of an out-of-shape body lessens and endurance increases, you'll discover other rewards from exercise as well:
It can be a great time to think about solutions to problems.
You can plan out the day or week while you exercise.
Some people report increased creative thoughts during exercise.
You may get a great feeling from the sense of accomplishment.
Because exercise often doesn't feel good in the beginning, setting up a self-reward system sometimes helps a great deal; later, other rewards will likely kick in.
Working in your workout
Today, people work longer hours than ever before, so it's tempting to think that the day doesn't hold enough time for exercise. However, it's all a matter of priorities; you won't find the time unless you plan for it.
That's right; you have to scrutinize your schedule seriously and work exercise into your life. Perhaps your job offers flex time, whereby you can choose to come in an hour later and stay later two or three times a week to have time to exercise in the morning, or perhaps you can exercise twice on the weekends and find just one time after work during the week. And it isn't all that difficult to add a little to your regular exercise periods. For example:
Park at a distance: Park your car about a 20-minute brisk walk away from your place of work once or twice a week.
Take the stairs: If you often take the elevator up five or six floors to work, try a brisk walk up the stairs several times a day instead.
Exercise during your breaks: If you get a couple of 10- or 15-minute breaks at work, try going for a brisk walk rather than standing around the water cooler. Two or three 10-minute periods of exercise do you the same amount of good as that one 20- or 30-minu
te period does.
How about exercise and panic?
Some people fear that exercise could set off panic attacks. In part, that's because exercise produces a few bodily symptoms, such as increased heart rate, that are similar to the symptoms of panic attacks, and those with a panic disorder sometimes respond to such symptoms with panic. However, if you go at exercise gradually, it can serve as a graded exposure task, as we discuss in Chapter 8. In other words, it can be an effective treatment approach for panic.
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