Although the actual risk is somewhat controversial, exercise can cause a buildup of lactic acid, which does seem to trigger panic attacks in a few people. However, over the long run, exercise also improves your body's ability to rid itself of lactic acid. Therefore, again, we recommend that if you fear having panic attacks as a result of exercise, simply go slowly. If you find it absolutely intolerable, stop exercising for a while or use other strategies in this book for reducing your panic attack frequency before going back to exercise.
The ABCs of Getting Your Zs
People generally need about eight hours of sleep per night. Seniors may need a little less sleep, but this idea remains controversial among scientists. Besides, the real gauge as to whether you're getting enough sleep is how you feel during the daytime, not the exact number of hours you get. In any case, anxiety frequently disrupts sleep, and a lack of sleep can increase your anxiety.
Many people have trouble falling asleep at night. As if falling asleep isn't hard enough, many people wake up before they want to, driven into high alert as anxious thoughts race through their consciousness.
The tendency toward an early-morning awakening with an inability to get back to sleep can be a sign of depression as well as anxiety. If your appetite changes, your energy decreases, your mood swings into low gear, your ability to concentrate diminishes, and you've lost interest in activities that you once found pleasurable, you may be clinically depressed. You should check with a mental-health practitioner or a physician to find out.
More goes into sleeping than just lying down and shutting your eyes. Factors that affect your sleep include the activities you do before you go to bed, your sleeping environment, and knowing what to do when sleep is elusive. We address these topics in the following sections.
Creating a sleep haven
Your sleep environment matters. Of course, some rare birds can sleep almost anywhere — on the couch, in a chair, on the floor, in the car, or even at their desk at work. On the other hand, most folks require the comfort of a bed and the right conditions. Sleep experts report that for a restful sleep, you should sleep in a room that's
Dark: You have a clock in your brain that tells you when it's time to sleep. Darkness helps set the clock by causing the brain to release melatonin, a hormone that helps to induce sleep. Consider putting up curtains that block out most of the sun if you find yourself awakened by the early morning light or you need to sleep during the day. Some people even wear masks to keep light out.
Cool: People sleep better in a cool room. If you feel cold, adding blankets is usually preferable to turning up the thermostat.
Quiet: If you live near a busy street or have loud neighbors, consider getting a fan or white noise generator to block out nuisance noises. The worst kind of noise is intermittent and unpredictable. If the noise is disturbing, the various kinds of sporadic noise that can be blocked out by a simple floor fan may amaze you.
Complete with a comfortable bed: Mattresses matter. If you sleep with someone else or a dog, make sure that everyone has enough room.
In other words, make your bedroom a retreat that looks inviting and cozy. Spoil yourself with high-thread-count sheets and pillowcases. You may want to try aromatherapy (see Chapter 12). No one knows for sure whether it works, but many people claim that the fragrance of lavender helps them sleep.
Following a few relaxing routines
Sleep revitalizes your physical and mental resources. Studies show that sleep deprivation causes people to drive as if they were under the influence of drugs or alcohol. Physicians without sufficient sleep make more errors. Sleep deprivation makes you irritable, crabby, anxious, and despondent.
Thus, you need to schedule a reasonable amount of time for sleep — at least seven or eight hours. Don't burn the candle at both ends. We don't care how much work you have on your plate; depriving yourself of sleep only makes you less productive and less pleasant to be around.
So first and foremost, allow sufficient time for sleep. But that's not enough if you have trouble with sleep, so we suggest that you look at the ideas in the subsections that follow to improve the quality of your sleep.
Whenever possible, go to bed at close to the same time every night. Many people like to stay up late on weekends, and that's fine if you're not having sleep problems, but if you are, we recommend sticking to the same schedule you follow on weeknights. You need a regular routine to prepare your mind for bed.
Associating sleep with your bed
One of the most important principles of sleep is to teach your brain to associate sleep with your bed. That means that when you get into bed, don't bring work along with you. Some people find that reading before bed relaxes them, and others like to watch a little TV before bed. That's fine if these activities work for you, but avoid doing them in bed.
If you go to bed and lie there for more than 20 or 30 minutes unable to fall asleep, get up. Again, the point is to train your brain to link your bed to sleep. You can train your brain to dislike getting up by taking on some unpleasant (though fairly passive, even boring) chore while you're awake. If you do this a number of times, your brain will find it easier to start feeling drowsy when you're in bed.
Winding down before hitting the hay
Some people find that taking a warm bath with fragrant oils or bath salts about an hour before hitting the hay is soothing. You may discover that soaking in a scented bath in a dimly lit bathroom while listening to relaxing music before going to bed is just the right ticket to solid slumber. Other people find the relaxation techniques we discuss in Chapters 11 and 12 quite helpful. Studies show that relaxation can improve sleep.
You need to wind down with passive activities before you turn in for the night. Therefore, don't do heavy exercise within a few hours of going to sleep. Almost any stimulating activity can interfere with sleep, even mental exertion. For example, we discovered, somewhat to our dismay, that if we work on writing an article or a book after 9 p.m., our brains continue to spin out thoughts and ideas well after bedtime. So we've changed our routine, and we don't write late in the evening.
Watching what you eat and drink
Obviously, you don't want to load up on caffeinated drinks within a couple of hours before going to bed. Don't forget that many sources other than coffee — colas, certain teas, chocolate, and certain pain relievers — contain caffeine. Of course, some people seem rather impervious to the effects of caffeine while others are better off not consuming any after lunch. Even if you haven't been bothered by caffeine in the past, you can develop sensitivity to it as you age. Consider caffeine's effects on you if you're having trouble sleeping.
Nicotine also revs up the body. Try to avoid smoking just prior to bed. Obviously, it's preferable to quit smoking entirely, but if you haven't been able to stop yet, at least watch how much you smoke before bedtime.
Alcohol relaxes the body and should be a great way of aiding sleep, but it isn't. That's because alcohol disrupts your sleep cycles. You don't get as much of the important REM sleep, and you may find yourself waking up early in the morning. However, some people find that drinking a glass or two of wine in the evening is relaxing. That's fine, but watch the amount.
Heavy meals prior to bed aren't such a great idea either; many people find that eating too much before bed causes mild discomfort. In addition, you may want to avoid highly spiced and/or fatty foods prior to bed. However, going to bed hungry is also a bad idea; the key is balance.
So what should you eat or drink before bed? Herbal teas, such as chamomile or valerian, have many advocates. We don't have much data on how well they work, but herbal teas are unlikely to interfere with sleep, and they're pleasant to drink. Some evidence supports eating a small carbohydrate snack before bedtime to help induce sleep.
Mellowing medication
Many people try treating their sleep problems with over-the-counter medications, many of which contain antihistamines that do help, but they can lead to drowsiness the next day. Occasion
al use of these medications is relatively safe for most. Herbal formulas, such as melatonin or valerian, may also help.
If your sleep problems are chronic, you should consult your doctor. A medication that you're already taking could possibly be interfering with your sleep. Your doctor may prescribe medication to help induce sleep. Many sleep medications become less effective over time, and some carry the risk of addiction. These potentially addictive medications are only used for a short period of time. On the other hand, a few sleep medications work as sleep aids for a longer time without leading to addiction. Talk about your sleep problem with your doctor for more information and help.
What to do when sleep just won't come
If you've been practicing the suggestions in the previous sections and still haven't resolved your sleep problems, we have a few more suggestions. Becky's story illustrates some of the problematic thoughts people have that keep them awake. Then we tell you what to do about them.
As the clock chimes the hour, Becky sighs, realizing that it's 2 a.m. and she has yet to fall asleep. She turns over and tries to be still so that she doesn't wake her husband. She thinks, "With everything I have to do tomorrow, if I don't sleep, I'll be a wreck. I hate not sleeping." She gets out of bed, goes into the bathroom, finds the bottle of melatonin, and pops three into her mouth. She's been taking them routinely for months, and they just don't seem to have the same effect that they did before.
She goes back to bed, tries to settle down, and worries about the bags under her eyes and what people will think. Her itchy, dry skin starts to crawl. She can't stand the feeling of lying in bed for an eternity without sleeping.
In Becky's mind, her lack of sleep turns into a catastrophe, and her pondering actually makes it far more difficult for her to fall asleep.
When you can't sleep, try to make the problem seem less catastrophic by
Reminding yourself that every single time that you failed to sleep in the past, somehow you got through the next day in spite of your lack of sleep the night before. It may not have been wonderful, but you did it.
Realizing that occasional sleep loss happens to everyone. Excessive worry can only aggravate the problem.
Getting up and distracting yourself with something else to do. This stops your mind from magnifying the problem and can also prevent you from associating your bed with not sleeping.
Concentrating solely on your breathing. See Chapters 11 and 13 for ideas on breathing, mindfulness, and staying in the present moment as opposed to focusing on thoughts about the negative effects of your sleeplessness.
Many people try taking daytime naps when they consistently fail to sleep at night. It sounds like a great solution, but unfortunately, it only compounds the problem. Frequent or prolonged naps disrupt your body's natural clock. If you must nap, make it a short power nap — no longer than 20 minutes.
Of course, a few unusual folks find that they can nap for just three or four minutes whenever they want during the day; they wake up refreshed and sleep well at night. If that's you, go ahead and nap. Most people simply can't do that.
Designing Calm Diets
Uncomfortable emotions cause some people to eat too much, others to seek so-called comfort food (full of fat and sugar), and still others to lose their appetites. Unfortunately, emotional eating only works for the very short run — perhaps a few minutes to an hour or so. In the long run, bad dieting habits increase distress either from weight gain or the negative impact on your body due to spikes in blood sugar levels or irregularity. So we recommend that you follow a few simple, well-known principles of good eating to stabilize both your body and mind.
Enjoying small, frequent portions
Portion sizes have expanded almost as dramatically as people's waistlines over the past century. Your great grandmother's china appears doll-sized by today's standards. In fact, some antique dealers report having trouble convincing customers that grandma's dinner plates really are dinner plates and not for bread or salad.
By and large, most people simply eat too much at one time today. Here are a few ways to control portions:
Use smaller plates: This creates an optical illusion, and you think you're eating more food than you really are.
Eat slowly: This gives your stomach time to tell your brain that you're full and should stop eating.
Fill your plate once, and put away the leftovers before you start eating: This removes the temptation to go back for seconds.
When you're at a restaurant, split a meal with a friend or box up half of it before you start eating: Restaurant portions are typically twice the size they should be for one meal. Eating only half of the meal provides the right amount of calories.
In other words, plan out what you want to eat and slow down your eating. Prepare several small, healthy snacks for dealing with cravings during the day.
Following nutritional common sense
For many people, the feeling of anxiety is similar to hunger. When stressed, a bowl of ice cream or some French fries with lots of ketchup sounds yummy, and those foods can momentarily boost moods. That's because they contain loads of simple carbohydrates. The body turns those carbs into sugar and burns it up like rocket fuel — really fast. That fast burn then leads to a rapid drop in blood sugar levels often leading to a plunging mood, irritability, and a return of sugar cravings.
Replacing those simple carbohydrates with food containing complex carbs and fiber maintains more stable blood sugar levels and a more stable mood. Complex carbs are found in unprocessed foods, fruits, vegetables, whole grains, and legumes.
Check out the Web site for the U.S. Department of Agriculture at www.mypyramid.gov. Go there to find personalized eating plans, weight-loss information, and recommended nutritional guidelines.
Chapter 11: Relaxation: The Five-Minute Solution
In This Chapter
Breathing your tension away
Practicing progressive muscle relaxation
Using relaxation techniques to thwart anxiety
Calling your senses into play
"I don't have time to relax. My life is far too hectic. I barely see my friends as it is now. I can't remember the last time I took a whole weekend off. I even neglect my own family. By the time the dinner dishes are put away, I can't think about anything else — I just collapse in front of the television or waste hours in front of my computer screen."
Does this sound like you or someone you care about? When contemplating making changes in their lives, people complain about having too little time more than anything else — including no time for relaxation.
We asked a wise yogi master how long he practices every day, fully expecting to hear the discouraging answer, "An hour or two." Imagine our surprise when he told us, "Five minutes." That's all he needs. He went on to explain that he usually takes more time, but he only commits to five minutes out of each day.
We listened to our teacher, and we now ask a mere five minutes of ourselves daily. Five minutes of relaxation a day has changed our lives. Everyone can find five minutes. And if you relax for five minutes, it may stretch into 10 or 20. But if it doesn't, that's okay. Relaxation will slowly infiltrate your life without you even knowing it, and when anxiety hits, you'll have a valuable tool for calming the storm within.
The relaxation procedures we give you in this chapter fall into three major categories: breathing techniques, ways to relax the body, and a few sensory experiences. Some of these can take a little longer at first to gain full mastery over, but they can all be done in five minutes when you get the hang of them. The key is daily practice. Like every other skill, the more you do it, the easier and faster it gets.
Blowing Anxiety Away
You've practiced breathing more than anything else in your life. In waking moments, you don't even think about breathing. Yet, of all biological functions, breathing is critical to life. You can go days or weeks without food and a couple of days without water but only minutes without breathing. You need oxygen to purify the blo
odstream, burn up waste products, and rejuvenate the body and mind. If you don't get enough oxygen, your thinking becomes sluggish, your blood pressure rises, and your heart rate increases. You also get dizzy, shaky, and depressed, and eventually you lose consciousness and die.
Many people react to stress with rapid, shallow breathing that throws off the desired ratio of oxygen to carbon dioxide in the blood. This phenomenon is called hyperventilation, and it causes a variety of distressing symptoms:
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