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 Mental Health FAQ's 

ANXIETY

 

Anxiety is often one of the most distressing emotions that a person feels. Anxiety can be experienced as perpetual nervousness. Symptoms of anxiety can include: jitteriness, sweaty palms, light-headedness, difficulty breathing, increased heart rate, and flushed cheeks. The meaning we take away from traumatic or painful events often leave us feeling very anxious due to thought patterns which can be formed in reaction to the event (e.g. overestimating danger in new situations, underestimating abilities to cope, fearing the worst will happen). Anxiety triggers our flight or freeze danger survival responses. This protective response system can be very helpful in assisting us to survive real danger. For example, fear is helpful when it warns us of danger and motivates us to avoid a dangerous situation (this is the protective role of fear). However, when fear is out of context (e.g. perpetual anxiety), it no longer serves us well. For example, when fear becomes internalized and associated with events or circumstances that are not actually threatening, it can cause problems in our life. Constant anxiety can be like a car alarm that rings continually when nobody is breaking in.

 

Anxious thoughts tend to focus on negative future events which often include many “what ifs” that focus on the worst-case scenario and predict danger or catastrophe. The focus on danger with the expectation or prediction of bad things can be a survival strategy where, the anticipation and prediction of bad things creates feelings of preparedness which, can bring some sense of safety, comfort or protection. However, engaging in these fear-based predictions causes our bodies to prepare for danger, thereby activating the fight, flight, freeze responses that create the discomfort of anxiety.

 

Pain producing beliefs associated with anxiety:

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  • Something bad is going to happen

  • I am going to die

  • If I trust, I will get hurt

  • It is just a matter of time before something bad happens

  • I must be absolutely perfect, or I will be rejected by others

SLEEP  DSPRIVATION

There are many reasons for not sleeping well which may include distress, physical discomfort or physical illness. Sleep needs vary. A baby starts life needing 16 hours or so of sleep each day. The time we need for sleep decreases as we get older, so that adults and particularly older adults may only need 4-6 hours a night. People's needs vary, but most people feel they need 7-8 hours, whilst others feel they need 9-10 hours a night. We might have difficulty getting to sleep, wake up frequently during the night, or wake too early in the morning and not be able to get back to sleep. These all result in feeling that we haven't slept enough - we feel tired, tense and are likely to worry about not sleeping. This worry can then make it even harder for us to sleep well.

When we go through a threatening event, it activates our body’s internal alarm system which pumps out adrenaline, in addition to a number of other chemicals to prepare our body for survival reactions. With post-traumatic stress, this alarm system gets stuck on high alert and can result in a number of unwanted symptoms. For example, if you have gone through a traumatic event, you might have a difficult time concentrating or remembering and might struggle with feeling irritable or easily angered. It is also common to feel constantly alert and to startle very easily. This state of alertness may make it difficult to fall or stay asleep. However, at the same time it can drain our energy reserves and create feelings of exhaustion

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If you have trouble sleeping, there are some things you can do to help yourself get a good night’s rest. These include making changes in:

  • Your environment

  • Your behaviour

  • Your thinking

 

Change Your Environment

Are there any helpful changes you can make?

  • Bedroom too light (or dark)

  • Bedroom too hot or too cold

  • Bedroom too noisy

  • Bed too uncomfortable

  • Partner, keeping you awake (snoring, restless etc.) 

  • Use your choice of relaxation technique before going to bed (whatever works for you)

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Change Your Behaviour

Use your choice of relaxation technique before going to bed (whatever works for you)

  • Do not go without sleep for a long time – keep to a regular pattern of going to bed and getting up at the same time every day, whether you are tired or not.

  • Keep the bed for sleep and sex. Don't use it for watching television, using computer etc.

  • Get some regular exercise during the day. Try some regular swimming or walking.

  • Avoid exercise late in the evening

  • Cut down on caffeine (some teas, coffee, some soft drinks) in the evening.

  • Try a milky drink or herbal tea instead. Do not drink a lot of alcohol. It may help you fall asleep, but you will almost certainly wake up during the night.

  • Do not eat or drink a lot, late at night. Try to have your evening meal early rather than late. If you have had a bad night, resist the temptation to sleep the next day – it will make it harder to get off to sleep the following night.

  • If something is troubling you and there is nothing you can do about it right away, try writing it down before going to bed and then tell yourself to deal with it tomorrow.

  • If you cannot sleep, do not lie there worrying about it. Get up and do something you find relaxing like reading or listening to quiet music (https://www.getselfhelp.co.uk//music.htm). After a while you should feel tired enough to go to bed again. Keep a Sleep Diary (https://www.getselfhelp.co.uk//docs/SleepDiary.pdf) for a week. When complete, you can look back and notice what helps you sleep better and what does not, so you can make positive changes and do more of what helps, and less of what does not. If nothing seems to help, try something different.

  • Speak to your doctor about your medication and how that might be affecting your sleep.

  • Avoid clock watching when in bed - put your attention somewhere restful, use imagery, mindful breathing, or your relaxation techniques.

Change Your Thinking

 

Worrying about not sleeping will keep you awake! Rather than put your focus of attention on the worrying thoughts, notice that they are just thoughts, then put your attention somewhere restful, use imagery, mindful breathing, or your relaxation techniques.

Remind yourself that worrying about it will not help, and that you probably are getting enough sleep, just less than you think you need. Our needs change as we get older.

If you are worrying about a particular problem, write it down, and tell yourself you can sort it in the morning.

 

CHECKLIST FOR BETTER SLEEP

 

Good sleep is influenced by many factors. Record how many of these things you have done in the last week and consider making changes to your routine.

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Things that are known to make sleep worse: 

  • Napping during the day. 

  • Watching television in bed. 

  • Using a device with a bright screen within the hour before bedtime (e.g., a smartphone, a laptop). 

  • Consuming drinks containing caffeine (includes tea, coffee, cola, energy drinks, hot chocolate). 

  • How many each day? 

  • What time of the day was your last caffeinated drink? (try to avoid caffeine after 6pm). 

  • Drinking alcohol (alcohol typically leads to interrupted sleep).

  • Eating a heavy meal less than 3 hours before bedtime. 

  • Staying in bed even if you cannot fall asleep (it is better to get up and do something relaxing, then try again later). 

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Things that are known to improve sleep; 

 

  • Regular exercise. 

  • How many times a week? (it is recommended to do at least 3 x 30 minutes per week). 

  • What time of the day? (it is best not to exercise in the 3-4 hours before bedtime). 

  • Setting aside some ‘worry time’ each day to write down any issues that are bothering or concerning you, then deciding to leave those worries behind until tomorrow (make sure to do this at least one hour before bedtime). 

  • Relaxation exercises (e.g., relaxed breathing exercises, progressive muscle relaxation). 

  • Having a relaxing bedtime routine (e.g., taking a bath or a shower, reading a comforting book). 

  • Setting the conditions for sleep. 

  • Make sure the bedroom is completely dark (blackout curtains are cheap and effective). 

  • Make sure the mattress and pillows are comfortable (make the bed an attractive place to be). 

  • Make sure the bedroom is the right temperature (think like Goldilocks: not too hot, not too cold). 

 

Other Tips 

 Number of tips for increasing the chances of having a good night’s sleep including: 

 

  • Follow a regular bedtime routine with a set bedtime. 

  • Create a calm atmosphere prior to bedtime. 

  • Listen to soothing music or relaxation tapes prior to bedtime. 

  • Practice relaxation exercises prior to bedtime. 

  • Drink a cup of warm milk (contains a natural sedative). 

  • Consult with your doctor about taking melatonin. 

  • Get physical exercise during the day. 

  • Spend time in prayer or meditation. 

  • Spend time in relaxing conversation with a loved one prior to bedtime. 

  • Read a book. 

  • Set aside a “worry time” during the day or create a “worry book” where you write down those things which you are worried which can be picked up and focused on during a specific time of day when you are awake. 

  • Use white noise or ear plugs. 

  • Relax in a warm bath prior to bedtime. 

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