Anxiety Management Techniques

Q&A with Dr Elaine Mayon-White, 'Seeing my friends has triggered my anxiety, what can I do?'

You can watch the short video here.

Sevcan:  For the last year I have been at home because of my treatment and then the pandemic happened.  The last year was really hard for me mentally, but I found a way to cope with it, on my own, whilst staying at home.  For the last month, I began working again.  I am working from home, but I am now seeing friends in person, with social distancing, and I find that seeing friends actually triggers my anxiety.  I was OK on my own and I was OK with diagnosis and all but now I can work and I can continue with my study, but when I see there's another form of life is going on with the people of my age, it kind of triggers my anxiety and I find it really hard to cope with.  Are there any suggestions for me?

Dr Elaine Mayon-White:  So tell me if I haven't understood this properly.  What you were saying is that there is one element of what I would call ‘social anxiety’, which is almost you re-entering the world after self-isolation and then also an anxiety because you're seeing other people in your peer group sort of go on with their life, without your restrictions.

So the first element of that, which is social anxiety, is actually really, really common as people moved out of isolation. And all that is happened is that by putting ourselves into isolation, we've created new behaviours. And covid has actually sent a new message to our brain that being around people is dangerous, so it triggers this limbic system. It triggers an anxiety response.  So, this is where rationalizing the anxiety and retraining that response is really important.

So it might be that what you do is rather than go for 30 minute socially distanced walk because you know that going to be too overwhelming and trigger too much anxiety, you do a 5 minute one.  And then once you've stayed with your anxiety for a little bit and it begins to turn off that signal, maybe do that walk a few times, then you do a 10 minute walk . And then gradually, as you expose yourself to more anxiety and your brain learns that you're OK, it will begin to turn off that signal. The important thing is that if you're with friends, you can hopefully you can share that to them that you're be experiencing some social anxiety as a result of putting yourself into isolation and they can be supportive of it.  So what I would say is it's one of those odd side effects of putting ourselves in isolation, is that for a proportion of the population that's actually created social anxiety. So you then actually have to treat that social anxiety. But I'd say be really confident because you know that before Covid you didn't have social anxiety. So it is just going to take a bit of planning, a bit of effort, and you should be able to gradually enjoy being with your friends again.

The other element, which is what you were saying about seeing your peers go on with their life - that's really, really hard and there's not really an easy way through it.  I think if you can talk about it with your friends, I think it's really helpful for people to understand where you're at.  People can't read our minds.  People have no idea what we're thinking or feeling half the time it's hard for us to understand. So, it's so important to find a way to share your narrative which feels safe and feels containing.  Obviously, no one has a right to know what's going on with you. But, if their friends are around, I would say think about what you can share to help them understand what's going on with you.

The reality is, is that your life is very different from your peers, and that's that's sad and it's awful. But there's no way to make that better. It's more about us adjusting to it and learning a way to communicate around it. The reality is, is that all of us die, but most of the time we live in denial about it, because that's not a place that we naturally go to. Actually, our brain doesn't want us to, that's why it triggers anxiety, it wants us away from death and illness as much as possible. But that uncertainty exists for all of us. When you get a cancer diagnosis, the real challenge is learning to live with that reality, whereas other people don't have to. So, I think this is where, I wish I could say you do this, and that technique, and it will remove that reality from you, but unfortunately, that is your reality.  So actually, it's more important to find a way to adjust and learn to live with it.  I'm not going to say the word ‘accept’ because I don't see why you should accept it. But I think you do have to find a way to recognize that there is a loss there.

You know, your life isn't akin to maybe some of your peers, and that is a loss. And we have to process loss in order to be able to find another pathway, if you like, or find a way to adjust our life. And again, coming back to that present moment can really be helpful. So, recognizing the loss, but then focusing on what you have here and now, and where you're at here and now, can be really helpful.

Sevcan:  Thank you.  I now understand in a better way, why I am feeling this way.

You can watch the short video of the discussion here.

Hi thank you, Elaine, that was really, really helpful, and it was just to make one small suggestion, something that's helped me is I'm giving permission to my family to tell me when they see the signs. There are particular things that I start to do as I'm entering into a bit of a sort of sticky situation. And I it's really helpful when my partner or my kids say, hang on, Mum. I think you going into that place a little bit now, just step back. And that has been really helpful because they're quite attuned to that now. And sometimes I'm not so attuned to it, interestingly. 

The question I had was I've had a lot of visual disturbances when I'm in a very difficult situation, like having a panic attack or something I literally can't see properly. And I don't know if that's related or not and I wondered what you thought of that.

It could be related to anxiety. I mean, obviously, you always have to get checked. And anything like that visual disturbance, get it checked medically. But yes, it could be. So, you know, we're all slightly different and the way we process things is slightly different. So, you know, it might be about thinking about whether breathing helps regulate it, or sometimes what people can do when they've got visual disturbances is they can shift what they're visualizing.  So, they can sort of allow and an image to take over the disturbance, which helps them bring down their anxiety, re-regulate, and then hopefully that bit of the physiology stabilizes and it kind of moves you on from that side effect.