Anxiety and worry

Some examples include the Mindfulness and Relaxation Centre at Beaumont Hospital, the Mater Wellbeing Centre or the Mindfulness and Compassion Centre.

There are lots of apps which offer relaxation and mindfulness exercises. Some examples include Headspace, Calm and Medito. Medito is free to use. Headspace and Calm are subscription-based.

Get a good night’s sleep. Try to get seven to nine hours of uninterrupted sleep every night. Get regular exercise. Exercise helps use up some of your nervous energy and releases feel-good endorphins. Eat a healthy diet. Limit alcohol.

Getting back to activities such as shopping or social situations can be scary at first. Give yourself time. Anxiety often settles with time and experience.

Sometimes, people will avoid certain things because of anxiety. This is especially true of situations that increase anxiety, like being in crowds, going out alone, exercise, sex or any activities linked to fear of stroke or falling. In the long term, avoiding these activities means you never learn to cope with them, so the anxiety keeps going. Plan to gradually do the things you avoid. Start small, and then build up slowly.

Plan for success when facing a situation that's making you anxious. If you know noise bothers you, go somewhere at a less busy time of day or ask to be seated somewhere quieter. Sunglasses may be helpful if bright lights bother you. If travelling, make a list of what you need to bring.

Notice worrying. People who worry a lot tend to imagine that the worst will happen and they won’t be able to cope. What is it that you are worrying about? If it's a current problem, can you do something to solve it? If so, what? If you can solve the problem, do it! If it’s not a problem that can be solved, there is no point worrying. Let it go.

Make time to see family and friends. Family and friends can help you feel relaxed. They may help you see things in a different light. Talking through solutions to problems can be helpful.

The Stress Control series can be a very useful place to start. It’s available online. It’s a six-week course on stress management, based on cognitive behavioural therapy principles. It’s free. You don’t need to register. Although it focuses mainly on stress, lots of the material will also apply to anxiety. It can be a helpful starting point for better understanding anxiety. 

If you have tried to reduce avoidance and to face feared situations gradually but you are still struggling to the point anxiety is having an effect on your relationships, work, leisure or social activities, you should speak to your doctor. Your doctor will be able to consider medication with you, or refer you for psychiatric support or talking therapy, or a combination. 

Sometimes medications can be helpful. Medications for anxiety can include benzodiazepines or anti-depressants.

Benzodiazepines are used in the short term for severe anxiety. They are not suitable for long-term use. Their effect wears off quickly, and they can cause withdrawal. Anti-depressants are used for longer-term anxiety and for situations where both anxiety and depression symptoms are present.

Your GP (family doctor) will discuss the risks and benefits with you. Anti-depressants can take a few weeks to take effect. Speak to your doctor if you want to know more about medication.

Start small, and then build up gradually. When putting yourself in feared situations, it is important to stay in the situation until your anxiety reduces by around half. This is so that your body, not just your mind, learns that the situation is actually safe. Make a plan to gradually do the things you normally avoid. For example, if you have been avoiding going out to dinner with friends since your stroke, you could start with a meal in a quiet restaurant with one close friend first. It will feel uncomfortable at the start, but the anxious feeling will slowly go away.

There are lots of things families or carers can do to support someone with anxiety.

Encourage basic relaxation. It’s often helpful if you engage in this too, so that your loved one can learn through observing you. Basic relaxation strategies can include controlled breathing, progressive muscle relaxation or imagery or meditation. Music can also be helpful. 

Encourage your loved one to participate in meaningful activities and daily routine.

In hospital, it can be helpful to personalise your loved one’s surroundings. This can include access to photos, music, a radio, their own clothes and important mementos. 

Highlight any improvements in your loved one’s condition, as they may not have noticed. This can help increase motivation and confidence. 

Discuss concerns openly. There may be a practical, solvable problem playing on your loved one’s mind, and working with them on a solution may help reduce worry. 

After discharge home, it’s important to be patient with your loved one. The person may need support to do tasks that cause feelings of anxiety. Slowly, the need for support should reduce as they build up their experience of managing situations successfully.

Pay attention to your loved one’s physical recovery, general health, medication adherence, sleep and nutrition. 

Phone: 01 668 5001

Email: referrals@irishheart.ie. 

Website:  irishheartfoundation.ie