Progressive muscle relaxation

Practice morning and evening every day. It is important to be in a quiet room. Remember to use calm abdominal breathing, except when you tense your stomach muscles. Tense each muscle group for about 10 seconds, then relax for 15-20 seconds. You can use the following order:

1.

Arms, chest and neck Bend your arms and cross them over your chest. Clench your fists and tense the arms, shoulders, chest and neck. Inhale while you tense the muscles and hold your breath. Exhale and relax all muscles.

2.

Face Grimace until you have tensed the face muscles. Tighten the lips and jaws. Inhale calmly and hold your breath a while. Then exhale while you relax.

3.

Stomach and lower back You might need to change to upper chest breathing while you tighten your stomach. Tighten your stomach muscles by sucking your stomach in. Hold, and then release. Change back to abdominal breathing as soon as you have relaxed.

4.

Legs Stretch your legs as much as possible. Tighten all muscles and pull your toes toward you. Keep this position while you breathe calmly for 10 seconds. Then relax for 15-20 seconds.

5.

Repeat and Relax Repeat the four exercises one more time. Then relax the entire body, try to feel the relaxation spreading throughout the body. Imagine a place you like, a beautiful and relaxing place like a seashore or in the woods. Continue relaxation for a few minutes and then open the eyes. Stretch and wake up, calm and relaxed.

Maybe you wish to obtain a professionally made tape with relaxation exercises or relaxing music. Several books, e.g. The Relaxation and Stress Reduction Workbook (see Books), contain more detailed and more comprehensive exercises than the one described above.

Meditation

During progressive muscle relaxation you relax the muscles and the mind follows. Meditation is almost the opposite. During meditation the mind is calmed, and the body follows. It is neither difficult nor mysterious. People with panic disorder may find this frightening since you must let go of the control to be able to meditate. And this makes it a very good exercise.

Focus on a word or your breathing. If you worry about your breathing, resulting in a anxiety, choose a word instead. Classical words are e.g. Om Shanti (means peace and calm) or So-Hum. But you can choose any word, from a poem or a song you like. If you want to focus on your breathing, only sense how air is passing in and out through your lungs. Sit or lie down comfortably with closed eyes. Let your thoughts come and go. It is difficult to think of nothing, but if your thoughts start wandering you should bring them back to your object of focus. Meditate for about 20 minutes, preferrably twice a day.

There is a lot of literature about meditation, and music on cd to meditate to. Many books on anxiety also describe meditation techniques. Alternative methods for relaxation include QiGong, Tai Chi, Yoga, massage or acupuncture. QiGong is also focused on abdominal breathing and being present in the moment.

Physical Exercise

What- this is not relaxation? Well, it is a very good way to make the body relax. You will not feel as tense and frustrated as before. And it is one of the most powerful tools against anxiety and panic attacks. During a panic attack your fight and flight reaction is activated, and you get a kick of adrenalin. Therefore, it is very good to allow the body to live out these tensions through physical activity. If you are in good physical trim the body will not become as tired by the panic attacks, which means that you will recover faster. When you work out, your body increases the production of endorfins, which make you feel good. Physical exercise must therefore be a part of your I-want-to-feel-better-program! Aerobics is the optimal exercise, but walking for 30 minutes every day is also useful. Or buy a skipping-rope, if you still suffer from severe agoraphobia.

Sleep

Persons with anxiety disorders often have sleeping problems. Panic attacks can sometimes wake you up during the night. And the antidepressants may disturb your sleep, but there are also medications that make you sleepy all the time. The doctor can help you find the most suitable medication and tell you WHEN to take it in order not to disturb your sleep. Sleeping pills can help during shorter periods, but addictive sleeping pills, such as benzodiazepines, can also result in disturbed sleep if used regularly. Some antihypertensives can give nightmares, and many antidepressives seem to increase the dreams at night.

Please find below some proposals for a good nights sleep:

The bedroom should be calm, cool, quiet and dark. Give yourself a good comfortable bed and surround it with things that you like. DO NOT use your bedroom for work! Ask the doctor if your medication might disturb your sleep. Try not to sleep on an empty stomach, but not too full either. Avoid conflicts and quarrel at bedtime. Try to relax, avoid disturbing TV shows or frightening books. If you wake up during the night, distract your thoughts until you can go back to sleep. Have some warm milk with honey, read a book or a magazine. If you feel stressed and worried about something that must be done, it can help to get up and write it down. Decide another time and place to think about it. Avoid checking the time. You can rest without sleeping, if you are relaxing in a dark room. If you need sleeping pills, avoid taking them every night since they may then lose the effect after a while.