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Overcoming Anxiety, Stress and Panic: A Five Areas Approach PDF

427 Pages·2012·8.52 MB·English
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overcoming anxiety, stress and panic a five areas approach third edition Dr Chris Williams MBChB BSc MMedSc MD FRCPsych BABCP Accredited CBT practitioner Professor of Psychosocial Psychiatry and Honorary Consultant Psychiatrist, Institute of Health and Wellbeing, University of Glasgow, UK www.llttf.com (free life skills support for this book) www.fiveareas.com (practitioner information about other Five Areas resources) CRC Press Taylor & Francis Group 6000 Broken Sound Parkway NW, Suite 300 Boca Raton, FL 33487-2742 © 2012 by Taylor & Francis Group, LLC CRC Press is an imprint of Taylor & Francis Group, an Informa business No claim to original U.S. Government works Version Date: 20121026 International Standard Book Number-13: 978-1-4441-6315-5 (eBook - PDF) This book contains information obtained from authentic and highly regarded sources. Reasonable efforts have been made to pub- lish reliable data and information, but the author and publisher cannot assume responsibility for the validity of all materials or the consequences of their use. The authors and publishers have attempted to trace the copyright holders of all material reproduced in this publication and apologize to copyright holders if permission to publish in this form has not been obtained. If any copyright material has not been acknowledged please write and let us know so we may rectify in any future reprint. Except as permitted under U.S. Copyright Law, no part of this book may be reprinted, reproduced, transmitted, or utilized in any form by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying, microfilming, and recording, or in any information storage or retrieval system, without written permission from the publishers. For permission to photocopy or use material electronically from this work, please access www.copyright.com (http://www.copy- right.com/) or contact the Copyright Clearance Center, Inc. (CCC), 222 Rosewood Drive, Danvers, MA 01923, 978-750-8400. CCC is a not-for-profit organization that provides licenses and registration for a variety of users. For organizations that have been granted a photocopy license by the CCC, a separate system of payment has been arranged. Trademark Notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe. Visit the Taylor & Francis Web site at http://www.taylorandfrancis.com and the CRC Press Web site at http://www.crcpress.com  Photocopying and accessible versions Permission is given for limited copying of this book by the purchaser where this is for use in the normal course of the purchaser’s business within the free-access healthcare industry and within small independent private healthcare clinics in relation to training and for client consultations. This permission extends to providing copies of the relevant part or parts of the book to a patient where relevant to a particular consultation. This permission does not allow copying or use by other healthcare professionals and therefore each practitioner in a clinical service using this book must have his or her own purchased copy. Nor does this permission extend to any purchaser working for or within a large commercial organisation, including but not limited to employment assistance programmes, health maintenance companies and insurance organisations. Such a purchaser or practitioner is not entitled to copy or otherwise use the book to assist members of any such organisation unless a commercial licence has been obtained from the publishers. If in doubt please contact the publishers, Hodder Arnold, at [email protected]. To obtain an accessible version of the book for use by the visually impaired, please contact: [email protected]. New ways of accessing the workbooks are currently under development. Please contact: [email protected] for more information. For translation requests: please contact [email protected]. Bulk copies Bulk copies of the book are also available at discounted rates direct from the publisher. To take advantage of these reduced rates, please contact Jane MacRae, Sales Development Manager, at: [email protected]. iii This page intentionally left blank  Contents Introduction vi Part 1 Understanding why you feel as you do Tackling your anxiety: starting out (... and how to keep going if you feel stuck) 1 Understanding worry and stress 29 Understanding panic and phobias 62 Understanding obsessive-compulsive symptoms (OCD) 99 Part 2 Making changes How to start fixing problems and finding solutions (practical problem solving) 139 How to ask for what you really need (being assertive) 162 Learning to be calmer, less annoyed and less irritated 176 How to get a good night’s sleep: overcoming anxiety and sleep problems 194 Using exercise to overcome stress 212 Things you do that worsen your anxiety (unhelpful behaviours) 225 Stress, alcohol and drugs 248 Facing fears and overcoming avoidance 263 Understanding and overcoming shyness and social phobia 288 Noticing and changing anxious thinking 322 Understanding and overcoming feelings of depersonalisation 355 Overcoming anxious overbreathing (hyperventilation) 370 Understanding and using anti-anxiety medication 387 Planning for the future 398 v Introduction Introduction Welcome to this third and fully updated edition of Overcoming Anxiety, Stress and Panic: A Five Areas Approach. Problems of anxiety and depression are common difficulties that can affect anyone at some stage in their lives. Anxiety can affect people in many different ways – worry, stress, panic attacks and phobias – which are the focus of this book. This book is designed to actively help you to: DD Learn important information about how anxiety, stress, panic or phobias can affect your life. DD Discover more about the ways in which you may react to physical illness, especially when facing the challenge of long-term illness. DD Find out how you can end up obsessing too much about things, and how to get out of compulsive habits. DD Work out why you are feeling as you do. DD Learn and practise some practical skills to help change how you feel. By following the clearly described tools in these workbooks, you can make helpful changes to your life. Who are the workbooks for? You may be using the workbooks for yourself, or perhaps you are a close friend or family member wanting to know more about anxiety and how to help. Many healthcare practitioners also use the workbooks in this series to support those they work with. Self-help approaches can be used by people with problems ranging from mild distress through to more severe anxiety or depression. The key thing is that you feel able to use the materials and want to use this approach. Using the workbooks The course involves reading the course workbooks and also putting into practice the things you are learning. Picking the right time to do the course is important. For example, if your concentration, energy or motivation levels are far lower than usual, you may find it very hard to keep your mind on things or to make changes. If you find that you are struggling to use the workbooks, or you feel worse as you work through them, please discuss this with your doctor or other healthcare practitioner. The course is not meant to replace getting the right level of support for more severe mental health problems. vi Introduction Which workbook should you use first? There is no right or wrong way to use the workbooks. Many people find it helpful to first read the workbook in Part 1: Tacklingyouranxiety:startingout(…andhowtokeepgoing ifyoufeelstuck). After reading this, pick out the workbook that most applies to your situation, that is, the main area you are having problems with (Understandingworry andstress, Understandingpanicandphobias, Understandingobsessive-compulsive symptomsor Understandinghowyourespondtophysicalhealthproblems). These workbooks will give you a good overview of the approach and will also help you to decide which of the Makingchanges workbooks in Part 2 of the book you should read. You can use as many or as few workbooks in the course as you wish. You will feel most motivated to try to make changes if you use the workbooks that tackle problems that you want to change. Key PoInt: The key to creating change in your life is using the workbooks and putting what you learn into practice. Getting help from others It can be hard making changes when you feel very stressed or low. Many people start off trying to improve things with lots of motivation. But part of feeling stressed is that you can sometimes quickly give up on change. That’s entirely normal and is very human (think how hard your friends find it keeping New Year resolutions even when they aren’t feeling worried about things!). Time and time again, people using resources like this have found the benefits of working with someone else to support and encourage them when things feel hard. We therefore suggest that you partner up with someone to help you as you use the course. For example, a health or social services worker, your doctor, a voluntary sector worker or a trusted family member or friend. vii Introduction The important thing is to have someone else there, helping you, discussing problems that seem hard – and to say well done when things move forwards. A word of encouragement Anxiety, stress and panic affect many people at some time in their life. Fortunately, it has now become clear that by changing certain thoughts and behaviour patterns you can greatly improve how you feel. The content of these workbooks is based on the cognitive behavioural therapy (CBT; a kind of talking treatment) approach. The developers of CBT have found many effective ways of tackling the common symptoms and problems people face when feeling low. This course is written in a way that clearly explains what to do, so that you can test the effect of these different suggestions in your own life. The workbooks aim to help you to regain a sense of control over how you feel. Theself-helpapproachcanreallywork Research has been done on people who use books like this one based on CBT. National treatment guidelines in England recommend the use of CBT self-help approaches like this as a treatment for anxiety, panic and phobias. It can also be helpful for obsessive- compulsive disorder (OCD) and helping you tackle longer-term health problems. The course can make a big difference if you can commit to using it. Makingacommitment Sometimes making changes is easier said (or written) than done. All of us feel discouraged and overwhelmed from time to time. This is even more likely when you feel distressed, anxious, tense or low. Therefore, try to make a commitment to use this course and to keep at it even if you feel discouraged or stuck for some time. To do this you will need to pace yourself. Having someone else to encourage you is also important. Also, be realistic. Bear in mind your motivation and energy levels so that you don’t try to do more than you can at one time. viii Introduction new online resources Various online resources are available to support users of the course: DD www.livinglifetothefull.com / www.llttf.com. Living Life to the Full is one of the most popular websites for people with anxiety, stress, panic and other problems such as low mood. It is run by a charity and is completely free to use. You can choose to just dip into modules or register to get access to lots of added content that provides valuable support: DD A forum to ask questions, or hear how others are getting on DD Mood-rating scales to help you check your progress DD 12 weekly support emails to help you keep on track. DD Different courses you can go through, which support various books in this series, including this one. Visit www.llttf.com to try it out at home or at an internet café; or a public library if you don’t have a computer. DD www.fiveareas.com. This website also has a list of other Five Areas resources, including self-help books, free handouts and downloads (including MP3s of relaxation techniques) and more. DD Check what new things are happening at our Facebook page at www.llttf.com/ facebook. This gives up-to-date information, and is the place to find out about new resources, research updates and more. Support modules at Books and other resources: Visit us on Facebook: www.llttf.com www.llttfshop.com www.llttf.com/facebook Watch out for The Worry Box Follow us on twitter at set of books @llttfnews About QR barcodes: If you have a smartphone, you can download free apps that allow you to use your phone to scan the above barcodes, which will automatically take you to the correct website. ix

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Overcoming Anxiety, Stress and Panic uses the proven and trusted five areas model of cognitive behavioural therapy (CBT) to help people experiencing a range of symptoms associated with these conditions. For the third edition, new workbooks are included on: obsessive compulsive disorder (OCD), using
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