Understanding and coping with anxiety

Breathlessness Advice and Support

Breathlessness Advice and Support is for those who:

  • Experience breathlessness at rest and/or during activity
  • Live with/support someone who suffers from breathlessness


Breathing problems are very common in people who have heart and lung conditions, cancer
and neurological conditions. Breathlessness can be disabling and frightening that can cause
increased feelings of anxiety.

This leaflet provides an understanding and basic advice on how to cope with anxiety.

What is Anxiety?

Anxiety is a normal response to a real or perceived threat. When we become anxious we
experience a range of symptoms that fall under 4 types of response. These responses to
anxiety include physical, cognitive, behavioural, and emotional aspects.

Physical symptoms include increased heart rate, shallow breathing, muscle tension, dry
mouth, sweating etc.

Cognitive responses (thoughts and images) include worries and fears about what will happen
in the future. Many of these thoughts or images may include negative content which can prolong
and maintain other symptoms of anxiety possibly leading to panic.

Behavioural responses can be aimed at either avoiding the anxiety or finding ways to cope
with it until it passes.

Emotional responses can be summed up in one word such as fear, terrified, scared, worried

There are many self-help strategies that can assist you to reduce your anxiety and several are
listed below. Firstly it can be helpful to learn to rate your anxiety on a scale of 1 – 10, 1 being
the lowest level of anxiety and 10 being totally overwhelmed by anxiety. This is important
because the more aware you become of your anxiety levels the better you will be able to
intervene as your anxiety rises. Remember anxiety does not last forever and it will subside
naturally. If you are particularly concerned by your anxiety speak with your Doctor.

Techniques to reduce your anxiety

Breathing techniques
Take in a deep breath and release, do this a minimum of three times. This can help to reduce
symptoms of anxiety as you feel it rising.

The 7/11 technique
Breathe in for 7 seconds and then immediately after breathe out for 11
seconds. If this is too much breathe in for 3 seconds and breathe out for 5 seconds. Repeat
this pattern of breathing for a minimum of 20 cycles at least three times a day when you are
beginning to feel your anxiety rise.

The clenched fist method
When you become anxious your body will become tense and this method can assist you in letting go of this tension. Find a quite space to sit, then clench your fist into a tight ball and hold this for around 5 seconds. Feel the tension in your hand and then after 5 seconds slowly release and unfold your fingers until they are straight. Repeat this process a further 3 times and pay particular attention to the feelings of relaxing your hand and letting go of the tension. The more you become aware of tension in your body the better you can become at releasing it.

Deep muscle relaxation
There are many audio CDs/downloads that will guide you through the process of deep muscle relaxation. This process involves setting aside 20-30 minutes a day to work through the major muscle groups in your body tensing and holding and releasing them as with the clenched fist method. Please ask a member of staff if you would like to be facilitated through the process.

Creating a safe place
This is a method that uses imagery to create a place in your mind’s
eye in which you feel safe and fully relaxed. This place can be anywhere that has meaning for
you and you will be asked to focus on all your 5 senses to enhance the power of this process.
Your 5 senses include sight, sound, taste, touch and smell.

Mindful awareness
This approach require you to bring your full attention to the flow of your breath as it passes in and out of your body. Whilst you are attending to the flow of breath thoughts and images will arise which may increase your anxiety levels. This approach teaches you to de-centre/gain distance from your thoughts/images and to just simply notice them as they arise in consciousness and fade away.

Identifying thoughts and assumptions that arise before and during anxiety 
Our thoughts have a distinct part to play in our experiences of anxiety as often people report such thoughts as “I’m going to die or this will never end or I can’t cope with this.” Thoughts like these add to and pro-long anxious experiences, thus it can be very important to record them on a sheet of paper or in a diary when and wherever we experience them. The idea of recording them is that the more awareness we have of our thoughts/images the more control we can have over our responses to them.

If you can learn to distract yourself when highly anxious it can be a very helpful means of coping with any symptoms that arise. The idea is that you engage yourself in an activity that requires your full concentration for a period of time until the symptoms subside. It can really help if you have someone who can take your mind of the current situation. Distraction is only a short term coping strategy.

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