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Mental wellness

October 02, 2017

How to deal with anxiety

You don’t have to live with panic attacks, phobias or other anxiety disorders — help is out there.

Fear of flying. Fear of public transit. Fear of public places. If you or someone close to you has experienced a phobia or had panic attacks, you know it can be debilitating. “Anxiety takes many forms,” says Toronto psychologist, Sarah Maddocks. “They include general anxiety, when you worry about most things; panic attacks, which can come out of the blue and trigger a fight-or-flight response; and phobias that can result in avoiding certain situations.”

That’s what I went through for a long while. In 2001, just after the attacks of 9/11, I was driving on the highway to my parents' home — something I had been doing often for many years — when my heart suddenly began pounding rapidly, my hands became sweaty and my legs turned to jelly. I thought I was going to die. I wondered if this was what a panic attack felt like. I got off the highway at the next exit, pulled over and tried to calm down. When I felt able, I continued my drive, but on the smaller roads rather than the highway. When I drove home later, I dared not take the highway.

I put the experience down to the recent shock of 9/11, and figured my panic attack was a one-off. But it wasn't. Each time I got on a highway when I was behind the wheel, it happened (I was okay as a passenger). I felt foolish; I’d loved driving since the age of 16. Could I never do it again?

I was so fearful of the fear itself that I avoided highway driving for the next 10 years. When I was driving, I took smaller roads, and my husband took the wheel on the highway. He and the close friends I told were very supportive, but if I was to get over this anxiety, I’d need professional help.

I finally decided to do just that not long after I took up road cycling. Riding for hours at a time gave me a ton of confidence and energy, and it was the empowering boost I needed to face my fears and take charge again. I booked my first-ever session with a psychologist.

We dealt with it by exposure therapy. She armed me with tools I'd need, such as breathing exercises and rationalization, to get me through the early stages of my journey back to the highway. In her office, she asked me to close my eyes and talk through each step of the route from my home onto the nearest highway, while she checked in with me at each virtual turn about how scared I was feeling on a scale of 1-10.

Then I was assigned practical exercises for “homework,” when I'd actually have to drive on the highway. This was truly terrifying. But I was to start small, driving for just a short stretch to the first exit, and returning home on the smaller roads. Next time, two exits, and so on. After a few weeks, I’d built up to the point where my fear was gone. I was free — and my roads remain wide open!

My experience with anxiety is common. “It’s my impression that there has been an increase in anxiety in recent years,” observes Maddocks. “There are multiple demands associated with work, finances and relationships with family, friends and loved ones. Achieving a happy balance of all of these is frequently a challenge. Fears can creep in about the future, and about how we’re going to manage. Anxiety is so prevalent, yet we don’t talk about it. We feel isolated and get caught up in it.”

Anxiety can make its presence known in different ways. “It shows itself as shortness of breath, a racing heart or sweating,” says Maddocks. It can disrupt sleep and wake you up with your mind racing. “It becomes intrusive. We start avoiding places or people if we start to feel anxious. It can lead to our stopping daily activities like driving, taking public transit and going to social events.”

A therapist can help to end the vicious cycle of avoidance. “A psychologist is trained to understand the phobia and do a focused analysis of what happened,” explains Maddocks. “If an anxiety attack happens during a certain situation, my procedure would be understand all parts of it. Anxiety is a learned response, so I call it unpacking the issue and then repacking it to get back to normal.”

If you do see a therapist or psychologist, don’t expect to be “fixed” without making an effort yourself. “We have to step into our fear and expose ourselves to it,” says Maddocks. But that’s done in a safe environment, and it’s taken a step at a time. “For the most part, you can lessen anxiety, and live your life without letting it intrude on or control your happiness.”

5 steps to tackling a panic attack

1. Identify and label it. Says Maddocks, “Tell yourself: ‘I’m experiencing anxiety.’”

2. Slow it down by taking stock. Rather than let the panic take control, demystify it by asking yourself: When does it happen? What does it do to reveal itself? How long does it last? Assessing what’s going on in your body is a way to take charge.

3. Tell someone you trust. You won’t feel so alone, and it can lessen the worry.

4. Look for help. You can see a professional therapist, or get self-help. “Look for information on mindfulness meditation or cognitive behavioural therapy (CBT),” suggests Maddocks. The Canadian Mental Health Association has information and resources, she adds. You can also consider mindfulness groups in your community or at your workplace. If your employer offers an employee assistance program (EAP) as part of your workplace benefits, that could be a good place to start.

5. Remember the basics. Breathing exercises have a calming effect, and are a key tactic for dealing with anxiety. Also, consider reducing the amount of caffeine you consume (it’s a stimulant), and getting more exercise. “Cardio exercise is proven to be very important in regulating mood,” says Maddocks.

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