{"id":7614,"date":"2020-06-30T08:24:15","date_gmt":"2020-06-30T07:24:15","guid":{"rendered":"https:\/\/www.thinkkidneys.nhs.uk\/kquip\/?p=7614"},"modified":"2020-08-10T15:48:15","modified_gmt":"2020-08-10T14:48:15","slug":"managing-anxiety-during-the-covid-19-pandemic","status":"publish","type":"post","link":"https:\/\/www.thinkkidneys.nhs.uk\/kquip\/blog\/managing-anxiety-during-the-covid-19-pandemic\/","title":{"rendered":"Managing Anxiety during the Covid-19 Pandemic"},"content":{"rendered":"\n

…with pre-planning, self-soothing and attention to changes in our body we can exert some control over anxiety and limit the extent of our reaction<\/p>Amanda Bevin, Renal Counselor, Kent and Canterbury NHS Foundation Trust<\/cite><\/blockquote>\n\n\n\n

Anxiety within the general population at\npresent is running high, and understandably our renal dialysis community who\nare vulnerable and shielding may be experiencing distress as they continue to\nattend their renal dialysis centre or satellite unit for life saving dialysis\ntreatments.  You may be experiencing\ndistress around your own safety and that of others; reduced staffing levels or\nadditional unfamiliar staff present in units or the ward; initial fast pace of\nchanging information and procedures; the triage system before entering units;\ndialysing in different units or areas to usual; asking yourself questions like\nhow do I shield myself when family members are going out to work, and I am\ngoing to dialysis where other patients or front-line workers are not wearing\nmasks or physical distancing. <\/p>\n\n\n\n

Firstly let\u2019s look to explain the response\nyou may notice when anxiety is experienced. \nAnxiety manifests itself in three ways:<\/p>\n\n\n\n

  1. How we think and what we say<\/li>
  2. How we behave<\/li>
  3. How we physically respond <\/li><\/ol>\n\n\n\n

    The fight\/flight\/freeze stress response is a coping strategy to protect ourselves from perceived danger. It is an automatic protective mechanism and not a conscious decision. However with pre-planning, self-soothing and attention to changes in our body we can exert some control over anxiety and limit the extent of our reaction.   <\/p>\n\n\n\n

    How our brains work<\/h2>\n\n\n\n

    The amygdala \u2013 an area of our brain responsible for fear, sends signals to the hypothalamus which in turn stimulates the autonomic nervous system (ANS) to release adrenaline and cortisol. The ANS consists of the sympathetic (SNS) and parasympathetic nervous systems (PNS). The SNS drives the fight-or-flight response, whilst the PNS drives the freezing response or puts the brake on. <\/p>\n\n\n\n

    Physical\nresponse: With the release of stress hormones we\nwill notice an increase in heart rate, faster and shallow breathing, reduced\npain perception, sweating, sharpened hearing and eyesight.  Anxiety impairs our cognitive function\nespecially our decision-making. When we are able to calm ourselves or\nself-soothe our cognition improves, allowing rational thought.<\/p>\n\n\n\n

    What you say to yourself, i.e. \u201cself talk\u201d \u2013 e.g. \u201cwhat if\u201d, \u201cshould have\u201d \u201cI must\u201d all increase anxiety. FEAR \u2013 False Evidence Appearing Real.  One way of challenging this thinking is to ask yourself – \u201cwhat factual evidence do I have to support these thoughts?\u201d. <\/p>\n\n\n\n

    Psychological response:  Or fear response (present or imminent) is a learned response to situations or behaviour. It is learnt through repeated exposure and we can experience over stimulation or catastrophic thinking as a consequence.  The more evidence\/experience an individual and collectively we have that we can cope with these extremes of emotions will demonstrate we have control over our anxiety, not the reverse. Practising relaxation techniques or mindfulness is one way of reducing our emotional responses. <\/p>\n\n\n\n

    Behavioural response:  In order to relieve anxiety\nsymptoms we will often avoid the situation to prevent feelings of distress, in\nthe short term relieving the anxiety but in the long term the issue or problem\nremains.  Therefore helping to alter our\nthinking style from avoidant to despite the presence of anxiety I can cope with\nthis situation \u2013 proving to the self there is another way of approaching\nthis.  Trying to fight or resist panic\nfeelings will usually only aggravate it. \nLearning to observe and go with it instead of reacting to the physical\nsymptoms is perhaps the most important behavioural shift to make.  Often feelings of panic are merely a front\nfor buried feelings of anger, frustration, grief or depression.  Try to recognise symptoms of suppressed\nfeelings by identifying what you are feeling and learn to express or\ncommunicate them to someone you trust are key coping strategies.<\/p>\n\n\n\n

    Suggestions to Cope during Covid 19 Pandemic<\/h2>\n\n\n\n

    If you are experiencing distress or you are noticing that your mood or behaviour is changing in a less positive manner please speak up, contact a friend or relative or professional counsellor or psychologist \u2013 let someone know that can provide a listening ear<\/p><\/blockquote>\n\n\n\n

    • Focus on the positive, what can be achieved, not what you can\u2019t \u2013 for e.g. if someone doesn\u2019t wear a mask in the unit \u2013 You can protect yourself with a mask, washing your hands regularly and asking the person to keep their distance in a polite and respectful manner<\/li>
    • Routine \u2013 Get dressed, don\u2019t stay in night clothes. Plan out your day alternating between being active and relaxed; take regular breaks, keep nourished; ensure good quality sleep \u2013 go to bed and get up at the same time each day<\/li>
    • Exercise \u2013 we may have to be inventive if we are unable to access the outdoors, engage with tv shows, internet \u2013 you-tube or app\u2019s; walking up and downstairs, walking around the garden for the equivalent of X steps or miles usually achieved daily, listening to uplifting music at the same time; or sitting in your chair doing arm or leg raises<\/li>
    • Limit contact with Covid-19 news updates or emails to once a day \u2013 view prime minister daily update, but not in the presence of children \u2013 try to shield them from worrying or distressing information in relation to the virus <\/li>
    • Practise self-care by listening to your body \u2013 what am I noticing now in this moment? Any tensions?  Introduce or continue your practise of yoga, tai chi or Pilates, using online free classes, introduce mindfulness practise to your life by downloading an app or google.<\/li>
    • Socialise using the medium of phone calls, texting, facetime, skype, or online chat rooms \u2013 be inventive with socialising online; dress up for dinner as you would if you were going out to a restaurant \u2013 have some fun \u2013 laughter is the best medicine! <\/li>
    • Time out \u2013 meditation, journal writing; adult colouring books, puzzles \u2013 something that allows your brain to be active and to switch-off from worries<\/li>
    • Book worry time- 5, 10, 15 minutes a day; outside of this write down the worry for later and then \u201clet it go\u201d; use the process of \u2013 can I do anything about this issue? If yes, go and do it now; if I can\u2019t now but I can address it tomorrow, then let it go for today and attend to when able; if answer is no \u2013 let it go; ask yourself \u2013 will any amount of worry time solve this or make it better? If the answer is no \u2013 let it go<\/li>
    • Letting it go \u2013 put the thought on a leaf; the leaf on a stream or river and watch it float off downstream until it is out of sight<\/li>
    • Learn something new \u2013 if you\u2019ve always wanted to do X and never had the time; ensure you log this into your daily routine or downtime<\/li>
    • Take one hour, morning, day or week at a time<\/li>
    • Use of imagery \u2013 think of an imaginary calming place – in as much detail as possible using all of your senses \u2013 what you can see, hear, smell, taste, feel, sense; who would you want with you, or are you alone?; temperature of environment, and notice how you feel as you imagine this calming place<\/li>
    • Whilst communicating with loved ones, stop and consider before responding \u2013 is what I was going to say something positive, or something they will appreciate or find helpful? If, not \u2013 don\u2019t say it; hold onto it and then find a way to let it go \u2013 maybe through breath \u2013 releasing tension as you exhale, or the leaf on a stream<\/li>
    • Think of something positive that can come out of this experience for you or your family.<\/li><\/ul>\n\n\n\n

      If you are experiencing distress or you are\nnoticing that your mood or behaviour is changing in a less positive manner\nplease speak up, contact a friend or relative or professional counsellor or\npsychologist \u2013 let someone know that can provide a listening ear.  At this time most professionals are offering\nappointments either online or via the telephone either.  If you don\u2019t have a specific renal\nprofessional in your unit, please contact Kidney Care UK. <\/p>\n","protected":false},"excerpt":{"rendered":"

      …with pre-planning, self-soothing and attention to changes in our body we can exert some control over anxiety and limit the extent of our reaction Amanda Bevin, Renal Counselor, Kent and Canterbury NHS Foundation Trust Anxiety within the general population at present is running high, and understandably our renal dialysis community who are vulnerable and shielding may be experiencing distress as they continue to attend their renal…<\/p>\n","protected":false},"author":133,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_bbp_topic_count":0,"_bbp_reply_count":0,"_bbp_total_topic_count":0,"_bbp_total_reply_count":0,"_bbp_voice_count":0,"_bbp_anonymous_reply_count":0,"_bbp_topic_count_hidden":0,"_bbp_reply_count_hidden":0,"_bbp_forum_subforum_count":0,"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"enabled":false},"version":2}},"categories":[1],"tags":[],"class_list":["post-7614","post","type-post","status-publish","format-standard","hentry","category-blog"],"acf":[],"yoast_head":"\nManaging Anxiety during the Covid-19 Pandemic - 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