Continued guilt, shame, and internalised stigma correlated to alcohol and other drug use

Managing moderate to intense anxiety often involves a combination of techniques that address both the mind and body. Here are some effective strategies:

1. Breathing Exercises: Practice slow, deep breathing to calm your nervous system. For example, inhale for a count of four, hold for four, and exhale for four.

2. Progressive Muscle Relaxation: Tense and then relax each muscle group in your body, starting from your toes and working upward.

3. Grounding Techniques: Use the 5-4-3-2-1 method to focus on your senses—identify 5 things you see, 4 you feel, 3 you hear, 2 you smell, and 1 you taste.

4. Mindfulness and Meditation: Engage in mindfulness practices to stay present and reduce anxious thoughts. Apps like Headspace or Calm can be helpful.

5. Physical Activity: Exercise, even a short walk, can release endorphins and reduce anxiety levels.

6. Cognitive Behavioural Techniques: Challenge negative thoughts by questioning their validity and replacing them with more balanced perspectives.

7. Healthy Lifestyle Choices: Maintain a consistent sleep schedule, eat nutritious meals, and limit caffeine and alcohol intake.

8. Journaling: Write down your thoughts and feelings to process them and identify triggers.

9. Social Support: Talk to trusted friends, family, or support groups to share your experiences and gain perspective.

10. Professional Help: If anxiety persists, consider seeking therapy or counselling. Techniques like Cognitive Behavioural Therapy (CBT) or medication prescribed by a professional can be highly effective.

When traditional strategies don’t seem effective for managing intense, chronic anxiety, there are additional approaches you can explore:

a. Therapeutic Modalities:

Acceptance and Commitment Therapy (ACT): Focuses on accepting anxious thoughts rather than fighting them, while committing to actions aligned with your values.

Dialectical Behavior Therapy (DBT): Combines mindfulness with skills for emotional regulation and distress tolerance.

Eye Movement Desensitisation and Reprocessing (EMDR): Often used for trauma-related anxiety, it helps reprocess distressing memories.

b. Medication:

Anti-anxiety medications or antidepressants may be prescribed by a psychiatrist. These can help manage symptoms when therapy alone isn’t sufficient.

c. Lifestyle Adjustments:

Explore dietary changes, such as reducing sugar and processed foods, which can impact mood and anxiety levels.

Incorporate consistent physical activity tailored to your preferences.

d. Support Groups:

Joining a group for individuals with anxiety can provide a sense of community and shared understanding.

e. Intensive Programs:

Consider enrolling in an intensive outpatient program (IOP) or residential treatment program for anxiety, which offers structured and comprehensive care.

f. Emerging Treatments:

Research into treatments like ketamine therapy or transcranial magnetic stimulation (TMS) shows promise for treatment-resistant anxiety.

g. Alternative Therapies:

Practices like acupuncture, yoga, or tai chi can promote relaxation and reduce anxiety.

Biofeedback and neurofeedback can help you gain control over physiological responses to stress. They are techniques that help individuals gain control over certain physiological and mental processes. Here’s a breakdown:

i. Biofeedback is a mind-body therapy that uses sensors to monitor physiological functions like heart rate, muscle tension, breathing, or skin temperature. The goal is to provide real-time feedback to help individuals learn how to regulate these functions consciously. For example:

Heart Rate Variability Biofeedback: Helps manage stress by teaching control over heart rate.

Muscle Tension Biofeedback: Useful for conditions like chronic pain or tension headaches.

By practicing biofeedback, people can develop skills to manage stress, anxiety, and other health conditions2.

ii. Neurofeedback, a specialised form of biofeedback, focuses on brain activity. It uses electroencephalography (EEG) to monitor brainwaves and provides feedback to help individuals regulate their brain function. For instance:

It can help with conditions like ADHD, anxiety, depression, and PTSD.

During a session, individuals might watch visual cues or listen to sounds that reflect their brainwave activity, learning to adjust their mental state for better focus or relaxation4.

Both techniques are non-invasive and can be effective tools for improving mental and physical well-being.

IMPORTANT NOTE: It’s necessary to consult with a mental health professional or medical doctor to tailor these options to your specific needs.

Human-Kind. Isn’t that lovely. We have moved away from the patriarchal term mankind – ‘man’ who has not always been ‘kind’, necessarily – toward equality between the sexes and acknowledging gender fluidity. Noah touches on this. If you’re interested in the evolution of humanity and how we are capable of co-operating as a global community, give this book a go. You may experience information overload – but when condensing 2.4 million years into less than 500 pages, Harari goes alright. I’m someone who didn’t pay attention to history at school so I found this book enlightening, empowering and also disheartening at times. Harari writes about the breakthroughs of the Cognitive, Agricultural and Scientific Revolutions. The power of human imagination, math and language has been instrumental in the development of humankind into an apex predator, and the destruction of everything else.

‘The stages of change model’ was developed by Prochaska and DiClemente. Heard of them? It informs the development of brief and ongoing intervention strategies by providing a framework for what interventions/strategies are useful for particular individuals. Practitioners need an understanding of which ‘stage of change’ a person is in so that the most appropriate strategy for the individual client is selected.

There are five common stages within the Stages of Change model and a 6th known as “relapse”:

1. In the precontemplation stage, the person is either unaware of a problem that needs to be addressed OR aware of it but unwilling to change the problematic behaviour [or a behaviour they want to change. It does not always have to be labelled as “problematic”].

2. This is followed by a contemplation stage, characterized by ambivalence regarding the problem behaviour and in which the advantages and disadvantages of the behaviour, and of changing it, are evaluated, leading in many cases to decision-making.

3. In the preparation stage, a resolution to change is made, accompanied by a commitment to a plan of action. It is not uncommon for an individual to return to the contemplation stage or stay in the preparation stage for a while, for many reasons.

4. This plan is executed in the action stage, in which the individual engages in activities designed to bring change about and in coping with difficulties that arise.

5. If successful action is sustained, the person moves to the maintenance stage, in which an effort is made to consolidate the changes that have been made. Once these changes have been integrated into the lifestyle, the individual exits from the stages of change.

6. Relapse, however, is common, and it may take several journeys around the cycle of change, known as “recycling”, before change becomes permanent i.e., a lifestyle change; a sustainable change.

(Adapted from Heather & Honekopp, 2017)