Anxiety is an uncomfortable emotion that can show up unannounced and be majorly disruptive to our day. People experience anxiety in a variety of situations like while driving, flying, having difficult conversations, public speaking, test taking, or in crowds. Sometimes anxiety can show up without any specific trigger.
Anxiety can present as having racing thoughts, indecisiveness, engaging in frequent “what if” or worst case scenario thinking. Often, anxiety can be accompanied by uncomfortable physical symptoms like shortness of breath, rapid heart rate, a sensation like butterflies in your stomach, dizziness, sweating, and more.
Anxiety is driven by a center in our brain responsible for activating the fight or flight system in anxiety-provoking situations. There are a variety of coping skills that can be used to calm this response and help to manage moments of anxiety.
5-4-3-2-1
This is a technique used to ground yourself in moments of high anxiety or emotional distress. By engaging your senses and bringing awareness to your surroundings it can help to reduce intense emotions and ground you in your body. Begin by scanning your environment and identifying the following:
5 things you can see: name 5 different items you can see, pay attention to small details and examine the item’s color, texture, or the way it catches the light.
4 things you can feel: identify 4 things that you feel within arms reach of your current position. Notice the sensations, the texture, the temperature, and weight of items.
3 things you can hear: listen closely and identify 3 things that you may have normally tuned out. Focus on each of these sounds for a moment and create a picture in your mind of what is causing the sounds.
2 things you can smell: notice the smell of the air around you or seek out 2 items in your surroundings with a distinct smell such as essential oils or a recently washed item of clothing. Take some deep breaths through your nose and emerge yourself in the scent.
1 thing you can taste: taste is a powerful sensation and eating a mint, chewing on some gum, or indulging in a favorite treat can be a good way to provide distraction. If you don’t have anything on hand you can name 1 thing you like about yourself or 1 thing you are grateful for.
Box Breathing
Box breathing or 4×4 breathing is another technique to manage anxiety and emotional distress. Box breathing helps to regulate your breath through timed breathing to engage your parasympathetic nervous system while also providing distraction.
Box breathing is done by either picturing a square box or using your finger to trace a square in the air or on the table in front of you. While tracing up the left hand side of the square you will inhale for 4 seconds, hold for 4 seconds as you go across the box, exhale for 4 seconds as you come down the right hand side, and hold for another 4 seconds while going across the bottom of the square.
During this exercise your breaths should be drawn out (think “one one thousand, two one thousand, three one thousand,” etc.). Repeat this exercise a handful of times until you feel more in control of your emotions.
TIP Skills
TIP skills were developed as a part of dialectical behavioral therapy or DBT and is known as a distress tolerance skill. TIP is an acronym for Temperature, Intense Exercise, and Paced Breathing/Paired Muscle Relaxation. Following the steps below engages the senses to reduce intense emotions and calm your thoughts.
Temperature: you can utilize change in temperature in a variety of ways. The standard DBT skill for temperature includes getting a large mixing bowl of ice water, holding your breath, and submerging your face in the water for 30 seconds. While uncomfortable, extremely cold temperatures help to decrease your heart rate. Other methods that you may use to engage temperature as distraction may include holding an ice pack on your forearm or the back of your neck, or taking a warm bath/shower.
Intense Exercise: intense exercise helps to use up your body’s stored energy, and this energy release can help to also expel pent up anxiety or emotions. The goal of this skill is to engage in intense exercise, just for a short while (a couple of minutes) to get your heart pumping and increase the rate of breathing. You could do so by engaging in jumping jacks, jogging, push ups, walking quickly, or any other physical activity that expels energy.
Paced Breathing: paced breathing helps to regulate and slow down your breathing. You can use box breathing as described above or any other breathing technique that has worked for you in the past. Another breathing exercise to use is the 4-3-7 method where you breathe in through your nose for 4 seconds, hold for 3 seconds, and exhale through your mouth for 7 seconds.
OR
Paired Muscle Relaxation: while taking a deep breath in, tense as many muscles in your body as you can and hold it for 5 seconds. While breathing out, think of the word “relax”, and relax all of your muscles while noticing the change in sensation in your body.
Final Remarks
In summary, anxiety and intense emotions can be uncomfortable and disruptive to our day to day lives. If you feel like you experience intense anxiety that is difficult to control and gets in the way of how you function, you may be struggling with an anxiety disorder.
At Calming Currents Psychiatry we are skilled in combining approaches to manage anxiety disorders which may include a combination of medication management, teaching coping skills, and using other mind-body techniques to help manage anxiety. If you are interested in learning more or scheduling an appointment you can do so by going to our website here: https://calmingcurrentspsychiatry.com/ or by calling/texting us at 715-402-4562