The following article on how to deal with an anxiety relapse contains affiliate links.
Given how much I’ve written about anxiety, you’d be forgiven for thinking that I’m finally done with the subject.
I’ve listed my anxiety symptoms, shared details of my panic disorder and spent hours on end talking about panic attacks.
I even have a Substack dedicated to the topic.
Even I’ve had to admit that writing about it makes me feel like a broken record.
Until, that is, I had an anxiety relapse.
It’s not the first time that anxiety has unexpectedly turned up at my front door; knocking cheerfully as though it was back from a long vacation. It’s something that first happened in 2010 and again in 2014, so perhaps it wasn’t a surprise when I heard the doorbell go in 2020; my relapse arriving in the form of relentless panic attacks.
Yet, although it might have been expected, it was still an event I found frightening. Anxiety relapses are normal, but that doesn’t make them any less scary.
So, what do you do when your anxiety comes back?
What does recovering from anxiety look like?
Previously, my own anxiety relapses have lasted a few months; each one de-railing me for weeks on end. This time, however, I was determined not to let it wash me away; to completely erase all the solid foundations that I’d carefully repaired the last time.
This time, I had a plan.
Of course, anxiety disorders, as with all mental health conditions, comes in an array of shapes and sizes, costumes and disguises. As such, there is no ‘one size fits all’ remedy when it comes to recovering from an anxiety relapse.
However, there are definitely techniques considered to be universally helpful, methods that have certainly helped me (especially with generalised anxiety disorder). So, if the rising tide of anxiety does begin to return, please don’t panic – don’t grab your lifebelt and whistle just yet.
Instead, have a read of the below, and see if you can help to gently guide anxiety and panic attacks back out the front door.
5 Ways to Deal with an Anxiety Relapse
1. Find the Source
When things like going food shopping suddenly feel unbearable, it can feel exhausting and irrelevant to have to analyse just why your anxiety relapse is happening, again.
But, an anxiety relapse rarely ‘just happens’. Your brain doesn’t simply decide one day that you’ve been calm and content for long enough, and you therefore deserve a splash of fear to spice things up. There would have been an event, an issue, a thought – or even an illness – that would have beckoned anxiety back (the link between illness, inflammation and anxiety is fascinating).
When I experienced my anxiety relapse in August, I spent a few weeks initially denying what was going on. I had no interest in assessing the chinks in my mental-health armour, or scanning the landscape for any underlying issues.
This was evidently the wrong course to take.
If you had a cough for a few weeks, you’d eventually visit the GP to see what’s going on. Perhaps you’ve got a virus or need some antibiotics, or maybe you need a trip to the hospital. But it would be unlikely that you’d simply let your ailment drag on – you’d want to know what is causing it.
The same is true for mental health, perhaps even more so. When you’re ready to acknowledge that anxiety has now resumed its place at your kitchen table, take an hour to sit down with a notepad and list any reasons or unresolved issues that might have caused its return.
Even getting these things down – making the problem clearer – is hugely helpful. Indeed, if you identify the problem, you can start to consider solutions. For example, a lot of my generalised anxiety disorder simply stemmed from spending too much time alone, without valuable structure or company. I was working at home constantly, rarely taking the time to work out of the house.
As a result, my days blurred into a long, lonely summer filled with anxiety symptoms. For someone who is uplifted and buoyed by the company of friends and colleagues, this was a big mistake.
Of course, that I was a bit lonely wasn’t the only reason for my anxiety relapse, but it certainly gave me food for thought. I started working remotely and getting out the house whenever I could, spending time with clients and making use of my gym’s work space. It was a small change to make, but one that made a world of difference.
Task: grab a pen and begin to note down anything that’s been worrying you lately. It could be a small thing: you’ve been feeling run down and are not sleeping well. Or it could be a bigger thing: troubles at work, for example. Try to identify what’s fuelling the anxiety and get the problem down, in black and white.
You might want to bang your head against the wall when reading this point.
However – and despite the fact it’s become something of a mental health cliché – the exercise card is an important one to play.
I’ve lost count of how many times my GP has asked if I’m exercising. Not (I hope) because I’m looking a bit out of shape, but because I’ve told him that I’m struggling with panic attacks or panic disorder.
In the past, as soon as he’d open his mouth to make this point, I’d immediately stop listening. It was like hearing your Mum ask you to tidy your room for the hundredth time. How could exercise even begin to help? I can’t even make it from my car to the local store without panicking, let alone run freely around a forest, or enter a room of sweating strangers.
Plus, with my metabolism working at an almost super-human speed, I had never been leaner.
However, since 2010, I’ve learned that when it comes to anxiety, exercise really is a silver bullet. As soon as my anxiety even hears the word ‘exercise’ it starts to worry; persuading me that it’s best to stay on the sofa with a packet of biscuits.
There are many persuasive biological, chemical and neurological reasons as to why exercise helps an anxiety relapse – and not least because you are utilising the excess adrenaline that so often fuels the disorder. From reducing inflammation, to promoting positive neural-growth, releasing happy-go-lucky endorphins to providing focus, distraction and a form of ‘moving meditation’, exercise is now even prescribed by the NHS to help combat poor mental health.
Since 2010, I’ve made exercise a regular part of my routine. Yet, over the summer – as apathy and anxiety crept in – I’d stopped exercising altogether. On reflection, that my mental health deteriorated hugely over this time is not surprising. I should have been more vigilant of my inertia and recognised just how much it was impacting my mood (especially my generalised anxiety disorder).
However, I soon realised that I needed to kick-start things again – and quickly. I therefore got my act together and started exercising.
Falling back into an exercise routine, mixing high intensity classes with yoga, had an immediate (and almost unbelievable) effect on my anxiety and was something I tried to do each time I was recovering from an anxiety attack. It’s undeniable that the mix of familiarity, routine and depression-busting hormones found in exercise, helped me to overcome my anxiety relapse.
The book ‘Jog On‘, by the fantastic Bella Mackie, details her experience of managing anxiety through running. And if you hate running? Then even a 30 minute walk a day can help to hugely alleviate feelings of anxiety and stress.
Task: are you exercising enough, or at all? Begin to carve out time in your day to get your heart pumping. A lunch time power walk? A quick YouTube exercise routine in the lounge? Some yoga before bed? Try to exercise at least 3 times a week for a minimum of 30 minutes. Be sure to also keep a diary to track your mood before and after exercise.
There’s something a little contrary about adding ‘acceptance’ to a blog post that promises solutions to your anxiety relapse.
Yet, there is a very real difference between simply suffering through an anxiety relapse and accepting it in order to move forward.
Nearly everyone I know who suffers with anxiety (and, that’s a lot of people), tend to pedal ‘perfectionist’ ideals. As they’ll tell you, all they want is for life to go smoothly. Perfectionists don’t want bumps in the road, or ‘learning curves’. They just want to be able to fulfil their roles and not be an inconvenience.
I don’t mind admitting that I’m a particular sucker for perfectionism. Consequently, and when I began to suspect that I was having an anxiety relapse, I found that my fears didn’t concern my own health or happiness, but how my anxiety relapse would affect the lives of others: colleagues, family and friends.
I obsessed over how this relapse in anxiety symptoms would stop things from being perfect. Instead they would be difficult and challenging; testing my relationships and ensuring my immediate downfall from any rose-covered pedestal. What if I had a panic attack in front of my boss? What if my panic disorder ruined an upcoming holiday for my partner? What if my anxiety symptoms meant my friends didn’t want to see me anymore?
In fact – and on reflection – it’s often these thoughts that haunt me the most when in the clutches of my anxiety disorder.
But, and as every perfectionist must learn, life is not smooth, nor is it bump-free. Instead, it’s difficult, hard and testing. People get sick, mess up and do questionable things. People fail exams, get B- in essays and turn up late for work. These things happen.
Over one phone call with a friend last summer – my anxiety relapse now firing on all cylinders – she shouted down the line: “You’re not perfect, Laura. And you never will be. Just stop trying”. It was jarring to hear. Perfectionist Laura felt as though she’d been shot.
Yet, slapped (metaphorically) with reality, I stopped both trying to cover up my anxiety disorders and apologising for them. I stopped worrying how it would impact my relationships or my reputation. Instead, I just accepted it for what it was. I was anxious.
Of course, I found this very difficult and made me feel like a burden. I could feel my crown slipping and the sensation made me panic. Yet on reflection, this acceptance was exactly what I needed to find.
For life’s perfectionists, this is an important lesson to learn. Accept people get anxious, life gets hard. But it won’t be the end of all ‘good’ things for you – like anything, it’ll pass.
Task: what is your biggest fear when it comes to anxiety? And how much are these fears related to thoughts concerning how you might burden or impact the lives of those around you?
4. Talking Therapy
Sometimes, when I hug my therapist, I feel as though she’s trying to peel me off her; like a celebrity delicately removing a hysterical fan.
Having met in 2010, this wonderful woman has patiently sat through my existential crises and my constant questions about my panic disorder. More than once, she’s told me that I don’t need her anymore, that she has no more advice to impart. Yet, cling to her I do and I’m all the more happier for it.
Over the last few years, I’ve repeatedly banged the drum for therapy – reiterating that if there is one thing you must do when experiencing returning anxiety symptoms, it’s to find someone to talk to. A therapist, a shrink, a counsellor, a support group – it doesn’t matter. Just make the time to sit down and rationalise your thoughts and feelings.
Therapists (particularly if you’re attending a course of CBT or Cognitive Behavioural Therapy) will fundamentally provide you with the tools and tactics to manage your anxiety relapse.
Indeed, so much of our anxiety is fuelled solely by our thoughts. By helping you to change those patterns of unhelpful thinking, a therapist can open up a whole new world. Indeed, who knew that your thoughts weren’t facts? That there are different ways of viewing the world? That 99% of what you think simply isn’t true?
If you knew that, how much better would you feel?
But more than that, a therapist simply offers a supportive and objective ear. Too often, burdened by our problems and embarrassed by our irrational thoughts, we dare not tell those closest to us what we’re thinking. Because of this, we tend to instead ruminate in isolation; allowing our irrational thoughts to multiply.
By seeking out a therapist, however, you can regain objectivity and rationalise these thoughts much faster – allowing you to pull yourself from anxiety’s quick sand.
Task: would you consider talking to someone about your anxiety, particularly if this anxiety relapse is just one of many? Cognitive Behavioural Therapy is an extremely helpful tool for anxious minds and I would whole-heartedly recommend talking to your GP about finding a CBT-trained therapist in the local area.
5. Tone Your Vagus Nerve
I’ll admit, I am relatively new to the activity of ‘vagal toning’.
However, as research into this important nerve accelerates, it’s becoming clear what a huge impact this part of our nervous system has in managing our anxiety symptoms.
In short, the vagus nerve is a cranial nerve that ‘wanders’ from our brain to our gut. As such, it touches upon nearly every one of our organs, alongside being in charge of both our sympathetic nervous system (or our ‘flight or fight’ response) and our parasympathetic system (the system that calms, relaxes and soothes us).
The vagus nerve is what switches us between these two modes – e.g. sending us into a panic, or alternating back to a calmer state of being. The lower your ‘vagal tone’, the more you’re likely to find it difficult to move between the two states; often getting stuck in a high anxiety ‘flight or fight’ mode.
The better your vagal tone, however, the easier and more responsively you’re able to push the break pedal on your anxiety – restoring calm faster.
There’s a huge amount of fascinating research about what causes low vagal tone, but it’s said it might even occur in the womb. Indeed, mothers with low vagal tone (i.e. who are perhaps stressed or anxious during pregnancy) tend to have children with similarly lower vagal tone.
However, there is fantastic news – this is all reversible. A bit like an arm muscle, you can ‘tone’ and train your vagus nerve so that you can harness and use it better; empowering yourself to find an exit route from your anxiety disorder.
There are a number of ways to do this.
Humming and meditation, which has long played a part in yogic traditions, is proven to help emit vibrations that gently activate your vagus nerve – releasing feelings of calm.
Likewise, cold water therapy (e.g. a cold shower or open water swimming) is shown to help, alongside deep and slow breathing, singing, the use of probiotics (due to the fact that your vagus nerve extends to your gut), exercise, laughing some specific exercises (found here).
I also recently invested in the celebrated Sensate device, a little gadget scientifically proven to help tone and gently stimulate your vague nerve. I cannot rave about this device enough and am already noticing my panic disorder improving, since using it daily (it also helps to stop my panic attacks, too).
6. Medication for Anxiety
There is a reason that I’ve left this part of the blog until the very end.
For many, talking about medication – specifically in relation to mental health – remains taboo. Whilst you’ll happily tell the pharmacist that you need Imodium for your loose bowels, admitting that you take mind-altering medication remains a hushed affair.
I understand this.
However, and without regurgitating the old adage: ‘taking an anti-depressant for your depression is no different to taking insulin for your diabetes’, I’m a firm believer that the use of anti-depressants must be more normalised.
In a podcast recorded last year, Claire and I talk honestly about how medication has, over the years, helped us enormously with managing severe anxiety symptoms (and helped minimise my panic attacks).
Like giving someone a little lift over a towering wall, anti-depressants have helped us to find the mental space, quiet and rationale to begin to deal with our anxiety disorders.
I often liken taking this medication to having a loud radio or TV station turned down. In the midst of anxiety, the irrational thoughts, worries and fears are all consuming. They don’t stop talking: each attempting to be heard over the other; muttering and shouting. As such, it can be difficult to see a way forward.
Although referred to as ‘happy pills’, anti-depressants have never made me feel euphoric. I’ve not woken up and skipped into the neighbouring field; singing to birds or embracing strangers.
Instead, I’ve simply noticed that as they take effect, the noise in my head quietens; anxiety’s dial turned down. Although undoubtedly there, I’m able to better compartmentalise anxiety’s thoughts and feelings, focusing instead on how I’m going to get better.
It’s a little like wrapping anxiety in Clingfilm: you can still see it, feel it and hear it. But it’s muffled and distorted.
Of course, for many, medication is a last resort, something I’m in full agreement with.
Each time I’ve decided to take a course of anti-depressants, it’s because I’ve got to a stage in which my life has become significantly restricted and I’m constantly plagued by anxiety attack symptoms.
Each course has given me the headspace to face my panic disorder relapse head-on, allowing me to get back behind the steering wheel of my mind. The medication has not transformed me into some euphoric caricature of myself, but has simply allowed me to get back to myself.
And for this, I’ll be forever grateful to those little pills.