Disclaimer: This post is not a substitution for professional medical care.
Sometimes people undergoing a significant life transition or living with a chronic condition develop anxiety, anxiety that can lead to a panic attack. As someone living with progressive FSH muscular dystrophy, I am one of those people.
The good news is that anxiety is treatable, even curable; and although unusually unpleasant, a panic attack generally passes relatively quickly without dire consequences.
That said, when the emotional wheels are thrown off track, it sure helps to know what to do to regain equilibrium – as soon as possible. What follows is my story, and the tools and techniques that I’ve found useful to better ride the waves of powerful emotions set off by anxiety. It is my hope that this shared experience may help others – with or without muscular dystrophy – find the relief they seek.
1. Quick fix
When there’s chest tightness due to mild anxiety, lying down with a hot water bottle placed lightly on my sternum has often brought instant relief.
When a water bottle is not available, a loving hand placed gently on the chest is a great substitute (and sometimes that hand is my own).
This technique was especially helpful in my early encounters with adjustment disorder with anxiety, (recently renamed by mental health professionals as “stress response syndrome”). The adult onset of FSH muscular dystrophy was starting to take its toll on the physical and emotional demands of daily living, and lying down while warming the heart soothed my being. It still does.
2. Better breathing
The quality of the breath and emotions are intertwined. Regulate the breath and the emotions will likewise follow.
When anxiety or a full blown panic attack strikes, huffing and puffing through the mouth (as if blowing out birthday cake candles over and over) is the sympathetic nervous system (SNS) naturally triggering the “flight-or-fight response.” Unless you really are being chased by a sabertooth tiger or threatened by some other danger that demands immediate escape, better breathing helps.
Repeat to yourself (or have a caregiver instruct you to do so as your steadying, verbal metronome):
“Breathe in calm, two, three, four;
Breathe out peace, two, three, four.”
- Choose two other positive, healing words that suit your in-and-out breath if so desired.
- On the out breath, imagine filling your atmosphere with peace (or your chosen healing word). Allow that peace to infuse your outer world.
- Aim to eventually breathe in through the nose, out through the mouth; then, as you calm, breathe in-and-out through the nose alone, further stimulating the beneficial effects of your parasympathetic nervous system (PNS).
- As you breathe out, consider sending out peace (or your chosen healing word) to others who are suffering. We are never alone.
- I also find this breathing technique helpful when having trouble falling asleep.
3. Move a muscle, change a feeling
Get out Despite slow mobility and limited range of motion, I try to get outside everyday. Fresh air and changing scenery short circuit any looping, stressful thoughts. To this end, my red scooter and power chair are anti-anxiety devices; they provide a way to move independently amongst nature’s healing powers.
During inclement weather, a car ride with my husband is also beneficial in keeping anxiety at bay.
The sight of seasonal change reminds me that everything is temporary, and that “this too shall pass.”
Strike a pose Yoga postures squeeze out the issues in our tissues, naturally calming the mind. Even if you require physical assistance like me, start stretching while breathing mindfully.
- Child’s Pose induces relaxation: the heart is lower than the head sending blood and energy towards the chest region where anxiety is often felt; and the majority of vital organs that are housed in the front body feel protected, reducing feelings of vulnerability. This posture is also helpful for inducing sleep.
Rinse off Swimming or, as is the case with me these days, bouncing in and under pool water, stimulates happy hormones. And as in yoga, the deep rhythmic breathing produces a relaxation effect and a rush of anxiety-busting endorphins (reference). As muscular dystrophy progresses, my husband and I have moved to sunny Arizona to maximize opportunities for outdoor water therapy.
Here is a link to our aqua therapy exercises: Video Shorts: Aqua Therapy for Muscular Dystrophy.
When swimming is not an option, a warm bath or shower calms my nerves. But it’s the rhythmic breathing in the pool that most significantly reduces anxiety.
Creative outlet Words, pictures and dance are informed movement of thought, and can positively reshape our relationship to even the most anxiety ridden internal dialogue. For me, writing, blogging, texting or talking about my fears dispel their hold, especially if it is honest, solution oriented, supportive, and if it all possible, laced with humor.
Fearful thoughts about the future trigger anxiety. Technology offers helpful tools that can (re)anchor the mind to the present moment.
Pandora My favorite comfort music channel is Meditation Spa Radio. The basic commercial free package has definitely been worth purchasing.
Insight Timer This free app offers helpful mediations, lectures, music and more. You can dial into specific topics (including anxiety) and likeminded community posts.
Audible Listening has become the new reading for me. My condition makes holding a book difficult and requires a lot of rest. Audible’s wide variety of books and many superb readers transport me to places where my anxieties can’t compete for headspace while needing to lie down. Excellent customer service and member benefits are an added plus.
5. Positivity power
Invest wisely Spend time with friends and family who are uplifting and positive. There’s nothing better than laughter or a supportive comment to halt the downward spiral into anxiety. Of course everyone has dark days and needs to vent from time to time. But if someone in your inner circle causes constant, unwarranted drama and regularly drains your emotional reserves, it is OK to radically rethink how much time, if any, you engage with that person.
This includes your health professionals. I once had a caregiver who commented on a sudden frustration I was having due to muscular dystrophy by bluntly saying, “Things are going to be hard for you for a very long time.” (So not helpful.) I let her go.
Today I am megablessed with a caregiver who is genuinely positive and makes me smile even on the toughest of days. She also understands anxiety. (More about what makes her such a wonderful caregiver in a future post.) The point is: for your mental well-being, choose wisely with whom you share your life; choose people who see a sky as partly sunny rather than party cloudy; choose to ride the unpredictable twists and turns of this human condition with individuals with whom you can mourn, weep, and bitch a little, but also with whom a delicious burst of lighthearted laughter wins out in the end.
Binge-watch mindfully Everything we watch leaves an imprint on us psychologically, even chemically. Watching comedy or life-affirming films best fuel my mind with gratitude for being alive while reducing anxiety.
Look on the bright side Surround yourself with images and inspirational messages that stimulate happy or meaningful thoughts.
6. Know thyself
Trigger awareness Before adult progression of muscular dystrophy set in, it took a lot to rattle my nerves. Not so now. I have become more sensitive to environmental and psychological stressors, and consciously managing my exposure to them is an important anti-anxiety practice.
Go gently Instead of beating myself up for feeling triggered, or what feels worse yet, crying (because it may or may not set off my husband’s irritability which is a big psychological stressor for me,) I try, try, try to recognize the heightened emotions for what they are: temporary and not my (nor my husband’s) “true self,” which is infinitely peaceful and perfect.
7. Rest more
Tiredness can blow any person’s mind-body connection fuse. That potential heightens with a stressful condition such as a progressive illness – for both caregivers and the person for whom they are caring. I have had to learn to stop and rest when I am getting tired; and be OK with lowering my expectations for how much I can do in a day. Otherwise, anxiety can seep into the frayed edges of my psyche. A well-timed nap while listening to meditative music is good anxiety prevention. The quality of my day has become more important than my quantity of perceived productivity.
Commonly prescribed anti-anxiety medications such as Xanax can also relax muscles, and definitely did not mix well with my muscular dystrophy. I became a human noodle on even the lowest dose. Eventually I settled on a low dose (10 mg) of Citalopram (Celexa). Prior, Lexapro made me extremely nauseous; Mirtazapine was helpful, but caused an unsightly facial rash and an appetite so intense that if it wasn’t nailed to the wall I ate it.
And like an ever increasing number of folks, I am finding anxiety relief from medical marijuana: Get Thee to a Dispensary: Managing Muscular Dystrophy with Medical Marijuana.
9. Maybe something else is going on?
After passing two kidney stones, elevated calcium levels and continued bouts of anxiety, I suspected something else was going on besides *just* progressing muscular dystrophy. I was right: countless doctors and counselors had missed the signals of hyperparathyroidism. You can read more about how I figured that out, and the subsequent surgery here. Since the removal of 3 ½ abnormal parathyroid glands, my anxiety levels have regulated quite a bit. Being an advocate for my own health paid off.
10. Keep going
To keep anxiety at bay, I know to manage my anxiety triggers, take a daily medication, and practice what I preach in this post. And that’s OK. It’s also OK that some days I do better than others. Like physical fitness, mental fitness takes practice and patience. Managing anxiety is a daily dedication to begin again, to seek the best methods for improvement and to trust the results will be worth every effort.