How to ease anxiety part 1: Individuals living with paralysis

Posted by Reeve Staff in Daily Dose on October 17, 2019 # Health

by contributing writer Terry Gupta

Content note: this blog contains a description of and discussion about anxiety.

That familiar sound. Someone’s at the door. You take a peek to see who’s there. You find worry and fear, pecking and pacing nervously. These two traveling companions are sometimes insistent, visiting frequently, and often persistent, especially if ignored. Do you answer the door today? Do you try to shoo them away?

Of course, this doorway is inside, to your awareness. If you’ve recognized these visitors for who they are, that’s a terrific start. If not, some of the telltale signs may include restlessness, nausea, sweating, quickened heart/respiration rate, ruminating thoughts and more.

Either way, they are knocking at our door to get our attention. Our body is on alert, from something real, remembered or perceived. If there is no imminent danger, we can aim to minimize or manage the effects of their visit. We can also aim to discern more about why they’ve come to call on us.

Anxiety and worry may have arrived prior to the experience of spinal cord injury (SCI), or may emerge afterward. Is anxiety a primary or secondary condition? Or, is it anxiety? Symptoms that look like anxiety may be related to physical realities like reduced respiratory function (breathlessness), lower blood pressure (dizziness), autonomic dysreflexia (sweating, rapid rise in blood pressure, etc.) and other conditions. Where possible, using best practices to address these conditions will help manage at least one layer of anxiety-like symptoms. This is another reason to know your baseline blood pressure, as well as a reminder to carry an autonomic dysreflexia medical alert card in your wallet. Consider requesting one from the Reeve Foundation. It’s free and has a place to fill in your information with a permanent marker.

Anxiety can also be a side effect of some medications. These may include some of the corticosteroids that treat pain, bronchitis, allergic reactions, arthritis and asthma. Certain headache medicines that contain caffeine, as well as medications for seizures, thyroid issues, weight loss, Parkinson’s Disease and other conditions may cause symptoms.

Some occasional anxiety is to be expected, in life in general, and particularly with a medical condition.

Emotional stress, trauma, learning and performing all of the new routines related to daily living after SCI can also cause varying degrees of anxiety.

Professional support

Anxiety may present itself as mild, moderate, severe or extremely severe. With an anxiety condition, the fear and worry are prolonged. Some examples include generalized anxiety, phobia-related or a panic disorder, which is most intense. With episodes of panic and/or suicidal thoughts, it’s critical to see your physician.

Overall, is your experience of anxiety interfering with daily life and tasks? Are you having trouble sleeping, or feeling depressed? These indicate it’s time to visit a behavioral health professional.

Thankfully, there are ways to re-set the body’s natural fear and worry cycles. Some of the nonpharmacologic methods might include cognitive behavioral therapy (CBT), dialectal behavioral therapy (DBT), somatic experiencing, positive psychology, eye movement desensitization and reprocessing (EDMR), hypnosis, specialized meditations, music therapy, etc.

If indicated, pharmacologic treatments may also be explored. Be sure you understand the potential side effects and adverse events of these medications before starting or stopping them. Several medications like benzodiazepines require medical oversight and tapering to discontinue. In general, it’s a good practice to learn about all of the medications and herbal remedies that you are taking. Check with your pharmacist for more information.

Self-care strategies

There are several self-help recommendations for anxiety. Learn all you can about the brain-based pathways of anxiety. As much as possible, de-mystify what is happening and why. Visit the Reeve Foundation for additional education and engage in peer support at Reeve Connect. You can also look online, at apps, or in your local library or bookstore for various resources. Many of these are designed to help you be more aware of and manage thoughts.

It is estimated that a significant portion of our thoughts are repeated. Is this true for you? Have you noticed if the majority of your thoughts are helpful? Unhelpful? Neutral? Do you think mostly about the past? Present? Future? Anxiety takes us out of the present and into worry about those future ‘what-ifs’ that can cause us to miss out on life experiences. Our power is in the present moment.

Practices like yoga (gentle movement, breath-based techniques, relaxation, mindfulness) can help us stay in the moment and observe the rise and fall of our body sensations, emotions, and reactions. The effects vary: some techniques relax and re-wire, while some will further energize the nervous system. Talk to a certified yoga therapist, to help you test and determine which techniques to use depending upon your fight/flight/freeze response.

Exercise and other activity builds our health and coping capacities, and boosts endorphins. Check with your doctor about what program is best suited for you. Scheduling activity time ensures that you don’t forget about it! Spending time with loved ones, including service animals trained to understand anxiety, can be especially comforting and protective.

Sleep is restorative and helps build our resilience. Good sleep hygiene practices are widely available and you can select those that adapt well into your daily routine.

On the topic of routines, exploring ways to streamline, simplify and/or automate can help prevent overwhelm. Setting reasonable goals that provide motivation without demoralization, especially if you tend toward perfectionism, can help address performance-related angst.

Follow your healthcare professional’s advice for diet and hydration. Certain food additives like food dyes, MSG and artificial flavorings can exacerbate anxiety. Similarly, alcohol, nicotine and stimulants (including caffeine and sugar) have links to anxiety.

In a November blog, we’ll focus more specifically on caregiver anxiety. You can also watch for a Reeve Foundation webinar that delves deeper into the topic of anxiety in December.

The next time anxiety and worry ring the bell, see about inviting them in for (decaf) tea and take a self-compassion break. Having even a few moments to be gentle toward ourselves can soften our raw impatience, be real with our vulnerability and reach a more nurturing space.

This blog is not intended to replace medical advice.

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Terry Gupta, MSW, C-IAYT, E-RYT500, YACEP, along with and her partner Jay Gupta, RPh, MSc, MTM Specialist, C-IAYT, is co-Founder of www.YogaCaps.org and www.RxRelax.com.