One to one specialist help for anxiety and depression in Bristol and Bath.

Anxiety and depression are subjects which deserve to be dealt with thoroughly and for this reason I have created a sibling website to offer resources and information specifically aimed to meet this need. For more detailed information specifically about Anxiety and Depression, I invite you to visit my sister website at www.anxietyspecialist.co.uk . At present some of the sections on the sister site mirror the information contained here, but over time the new website will be continually updated with new articles and information. For now the new website contains enough information to make a visit worthwhile, so please do take a look if you have time. In the meantime the following will give a nice overview of some of the considerations one might make when approaching a solution to anxiety and depression.

This is an article I originally wrote for the website www.nomorepanic.co.uk. This site is a wonderful  resource for anybody looking for help with panic, depression or anxiety. I include this article on my website as a number of people have commented that they found it extremely helpful, and it offers some understanding as to how and why hypnotherapy can be a very valuable tool in dealing with these states. Even if you are not based in Bristol or Bath, or are not considering hypnotherapy as a form of treatment, I hope you will still find this article to be useful to you. 

I'd like to share with you a little of my knowledge and experience in the hope that you might take something from it that you can use towards recovery. 

Anxiety and depression is fighting talk. There's no doubt about it. Being chronically anxious or depressed is about the most miserable thing a person can encounter in a lifetime, and to a greater or lesser degree, most people will have a brush with these states at some point during their lives. Mercifully, for most, it's a short lived affair, but for others the battle deepens….weeks turn into months and months into years. It can seem as though there is no way out. It can also seem like you're the only one who ever felt "like this"….but rest assured, you're far from being the first, or the last to have these feelings. It's interesting to me how many people have such similar symptoms even when those symptoms seem to be so personal and unique. 

Allow me to offer a new perspective. First of all, let's just challenge the assumption that you are a "depressed" or "anxious" person (By nature). A much more accurate and hope inspiring description is that you are a "normal" person who is suffering with an inappropriate depressed or anxious response, either to life in general or to a given situation. Depression and anxiety may be viewed as a learned behaviour (albeit an unconscious learned behaviour) rather than an affliction which is imposed upon us from the outside-in. There is an important distinction to be made here.

Acceptance of the belief that you are a "depressive type" is immediately disempowering to you. It implies that you accept your role as a depressed or anxious person, and it also implies that depression or anxiety is a permanent state …a part of your nature. Though still a contentious subject, modern research (See Michael Yapko/ Joe Griffin), strongly suggests that the idea that depression is purely genetic is flawed. The picture is actually a lot more complicated than that. Genetics may have a small part to play but no "anxiety/depression gene" has been identified, and the research suggests that such a gene will not be found. If this is so then we must search for other reasons. We don't have to look too far. Where anxiety and depression runs in families, it's easy to recognise that it will be difficult for children, or even husbands and wives, to emerge from such families with good coping skills and a strong sense of confidence. 

Put simply, we learn a great deal about our environment from those around us, and if we are around people who continually see the worst in things, then it will be very difficult for us to find a positive focus in our own lives. If we are continually told that "it's a bad world", it will be difficult for us to believe any differently. Repetition of any idea be it good or bad will create a programme in the mind which will colour all of our experience. The idea that depression or anxiety is handed down purely genetically largely overlooks this factor. In the same way, modern medicine also offers us a view of depression or anxiety as a dysfunction of brain chemistry. 

Whilst it is without question that anxiety and depression will produce very powerful changes in brain chemistry, what is not commonly recognised is that these changes are at least in part the RESULT and not entirely the CAUSE of depression or anxiety. Understanding this means that we have a little bit of leverage in approaching a solution to anxiety and depression, because it means that we are not at the mercy of our chemistry. In fact, we can go further and recognise that our brain chemistry actually responds very readily to the way we think and feel about life, which means that we do have a way in, to break the cycle. You can see therefore that if your fundamental belief about your life is that you are a depressive or anxious type then this is the message you will send to your subconscious mind. 

Since you will have accepted the idea that you are an anxious/depressive type at a conscious level, then the subconscious mind, being a non-deliberating mind will accept this idea and implement what it believes to be an appropriate response. Our biofeedback systems, being the adaptable systems they are, will respond accordingly, and oblige us with the internal chemistry which matches that belief (i.e a depressed or anxious state). Viewed this way, we can understand that the chemical states we experience when we are depressed or anxious are at least partially a result of our beliefs and perceptions rather than the cause of them. Whilst pressures upon us may well be overwhelming at certain times in our lives, at some level, chronic depression or anxiety is a result of that modality being accepted as the norm rather than the temporary extreme…the driving factor being that the mind has taken on board the erroneous belief that life in general is filled with danger and that the organism must therefore be protected at all costs. Prolonged exposure to highly stressful living is a major factor in creating these states. 

Thus we have our two symptoms. Depression requires that we withdraw from life, minimising our chance of being damaged by life, and anxiety requires that we engage with life but that we remain on Red, Orange , or Yellow Alert status. That is, that we must remain in fight or flight mode in order to deal with the life threatening situations we are sure to encounter in such a dangerous environment (At least according to the subconscious mind with its current belief that life is dangerous). In accepting the label of an anxious or depressive type, it makes it far more difficult to separate yourself from the symptom. If you believe fundamentally that you ARE the symptom, (i.e I am a depressive) then asking yourself not to be depressed or anxious is like asking yourself not to be you! So, the first thing to get straight in your mind is that you are NOT the symptom. You are You…..and the symptom, the anxiety, compulsive behaviour, anger or depression, is a response. I'll explain.

Our ancestors endured unbelievable hardship to get us here. Droughts, famines, ice ages! In a world of much fewer people, the primary consideration was survival and the continuation of the species. This meant shelter, food, and procreation was paramount and securing these all important facets of existence was never without its dangers! And so we have our instinctual responses. These can be roughly summarised as follows:-

· Fear - The flight (run away) response
· Anger- The stand fight and protect response
· Depression- The withdraw and conserve energy response

These responses are instinctual. That is, they take precedence over our ordinary "will" because they are programmed in to us at the most fundamental level of our being. They are designed to ensure the survival of the species and the individual and as such will naturally override the rational logical thinking mind. So, beginning with anxiety- A human being coming face to face with a wild hungry tiger will need to act instinctively if there is to be any chance of survival. This means that this person will move into a high alert mode without any conscious effort at all. This person will move immediately into a trance-like state. Adrenalines (powerful chemically stimulating hormones) will flood his nervous system. Blood supply will be maximised to the limbs as they are primed for fight or flight with extra oxygen. He will become hyper-vigilant. His hearing will be fine tuned to pick up on the slightest changes in the environment. The hairs on his arms and the back of his neck may stand up. His peripheral vision will switch to high alert and he will be sensitive to the slightest movement. In short he will be primed to perform physically and mentally to the absolute edge of his capabilities….and all without ever giving the process a single thought. All of these changes are completely automatic…..instinctual! 

Now, we can be grateful for this. Should we ever find that we have wandered into a dangerous situation, we can be sure that these responses will serve our survival just as powerfully today as they served our ancestors, but the problems come for us when these responses are triggered inappropriately. 

Living as we do in the modern Western World, it is rare for us to run into any truly life threatening situations, but we have lived in this relative security for only a short period of time in evolutionary terms, and adaptable as we are, we are still honed to respond instinctively to danger in the environment. In the absence of wild tigers, we have found a different danger in our environment…..at least as far as our survival mechanism is concerned- Stress. Why stress? Well…let's get back to basics. Again, at the most basic level, we are programmed to seek to have our needs met. 

The most basic of these needs can be roughly summarised as food, shelter, security, happiness, companionship, love, adventure, freedom, etc etc. Stress is a result of any one of these (or other) needs being either removed, or challenged in a way which threatens to rule out future access. We can see that there are many situations which will directly relate to these issues. If we are ending a relationship we are losing companionship, community, belonging, safety. If we are having trouble finding a job, we may feel threatened by the possibility that we will not be able to obtain food. Being stuck in a traffic jam can be perceived as a threat to our freedom! 

Essentially, all of today's modern stresses can still press the basic primitive necessity/survival buttons. Stress is also created when there is unresolved conflict present in our lives, particularly where that conflict is internal, so thinking and perceiving negatively can also be included as a major factor in creating stress. So we can see that there are many ways in which stress can be created. Now when there is too much stress in a person's life, this will be interpreted by the subconscious mind, at an instinctive level, at the survival level, as danger in the environment. We can see that not having needs met, and negatively forecasting (thinking/assuming the worst) can be interpreted as a threat to the continuation of the individual and of the species as far as the mind is concerned because we will be feeding an image of future misery (helplessness) to the subconscious mind. 

When the future is considered to be filled with danger (helplessness) then the mind decides that it's not safe and obliges us with anxiety as a means of helping us to remain physically and mentally prepared to deal with hostility or depression as a means of withdrawal from life altogether. These states are nicely self perpetuating with anxiety creating more anxiety and helplessness and depression deepening as life becomes ever more meaningless as we continue to withdraw……and so the cycle continues! 

So….what is to be done? Well…..the good news is that as there is a way in, so too is there a way out. Both anxiety and depression can be successfully treated when approached with the right kind of understanding, which involves essentially working backwards using the understanding given above. We will all be familiar with the saying that we can't see the wood for the trees. This is especially true in relation to being depressed or anxious. Being adrift at sea for a long time with no sight of land could lead one to form the erroneous conclusion that there is no land, but rationally, it is always possible to remind oneself that there IS land. 

So, it is important to remember that even though things may look very dark now, it is fundamentally incorrect to assume that things will remain that way indefinitely. Indeed to do so is the surest way of ensuring that things don't improve! We know that when we are anxious or depressed we can lose sight of the higher intelligence we have access to when we are calm and relaxed and start to think in very literal black and white modes of thought. This means that we see things as good or bad. Light or Dark. Safe or Dangerous. Since we are negatively focused anyway, the majority of the time we will find the worst in things. It also means that we are unable to see clearly all of the possibilities of escape from our situation. If we don't recognise that we are thinking in this black and white style, then we can make the mistake of believing that the negative conclusions we have arrived at are complete and correct. If we believe our own negative introspections, then we continue to make it impossible to move out of the cycle of anxiety or depression. 

Somebody who is anxious or depressed will find it difficult to cope with ambiguity. This means that it is difficult for that person to be able to put an issue aside and say "I don't know how this will turn out…..and I will choose NOT to worry about it in the meantime….." So it is necessary to take a leap of faith in the beginning. One has to say "I know I cannot at this moment in time see clearly all of the options available to me, but despite the negative images and thoughts which are coming in, I can still choose to know that re-engaging with life will be positive for me, even if it is difficult right now" The leap of faith here is the faith that you will emerge from the woods by moving towards that life of security and joy REGARDLESS of whether you feel depressed or anxious; hence the expression "Feel the fear and do it anyway". 

Giving-in to anxiety sends the wrong message. It tells the subconscious mind that we agree with its assumption that our life is endangered and reinforces the inappropriate response. In order however to be able to challenge our own black and white styles of thinking and false assumptions it is first necessary to dissect the issues so that we fully understand them at a rational level. It should be noted here of course that we know that the responses themselves are irrational, that is, they are neither conscious nor necessary, but we take the first steps towards healing by at least having the knowledge about our issues readily available in order that we can challenge our false assumptions as they arise rather than placidly accept them as truth, thus compounding our difficulties as is so often the case. 

Typically, negatively focused people will think hurtful things and then make the mistake of believing them themselves. Often this will be in the style of sweeping generalisations such as "The World is a terrible place"……"I'll never recover from this illness…."…."Ten years I've wasted…." I'll never pass my exams"….."If I had only …….then I'd never be in this mess" etc. 

As an example, using the above. "The World is a terrible place…." How might we challenge that assumption? If we were to sit with pen and paper and list what is good about the world and what is bad about the world, then we would find clearly that there are some aspects to the world which are, or seem, terrible, but that there are also aspects to the world which are clearly beautiful and joyful (We can KNOW this even if we don't FEEL it right now….we are looking for objectivity in this exercise since it is this rational style of thought which we will use initially to challenge our false assumptions) Also, we would find many aspects which could be seen either way according to who is doing the seeing. Thus we have ambiguity in the world and the same is true of our lives. We can see rationally that the assumption that the world is a terrible place is actually fundamentally flawed. The truth of the matter is that it is terrible, beautiful and indifferent. It is filled with ambiguity. The question then becomes not "what is it?", but "how will I choose to relate to it?"

So, you could begin by concentrating on at least one single major aspect of your life, challenging any negative thoughts which arise in relation to that aspect. 

Begin by sitting down at the start of the week and listing all the points you can make. 

· What is good about the situation? 
· What is bad about the situation? 
· What would be the most positive perspective you could have on this situation? 
· What is the most negative perspective you could have on this situation? 
· And what don't you know about the situation? 

Invariably this will include the fact that you don't actually know how it will turn out. Logically, you can reason therefore that you are much more likely to achieve solution if you are positively focused and you can therefore decide to take the positive optimistic view as a strategy for success…or if this is not possible, you will at least be content with saying to yourself…"I don't know how this will turn out….but this is no reason to assume that it will turn out badly". Once you have rationally dissected the issue, you will have an absolute picture of the rational REALITY of the situation in mind. Now…..any negative assumptions which arise in relation to that situation can be immediately challenged on appearance. Continually challenging negative assumptions in this way will lead to the formation of a new habitual pattern of thinking. That new pattern will be much more positively focused, and bit by bit, as we learn to think more positively, we find that our feelings adjust accordingly.

Learning also to deal with adversity by reminding yourself that it's transient and that, however devastating it may seem at the time, your life encompasses much more than that, is the perspective of resilience. Learning to distinguish between facts and inferences and how your feelings can deceive you into believing something that isn't really true is a vital skill to master (Michael Yapko). 

Remember that as you continually practice challenging negative assumptions and finding instead the positive perspectives on situations you will be learning the habit of thinking positively. Over time, you will begin to move naturally into a positive thinking style as your efforts become habit. 

Remember also that this process does not take place in isolation. In order to maximise control in your thinking processes, it is also necessary to ensure that you are sending a message of safety and relaxation to your subconscious mind. This means ensuring that you are taking time out to relax deeply. There are many ways that you can do this, Even if you are very anxious generally, you can learn techniques which will help you to relax. Do challenge the thought that says "I'm too anxious to relax!". It's usually an incorrect assumption. It may be true that you feel too anxious to relax generally, but most people can learn techniques to relax momentarily. 

Hypnosis is probably unequalled in effectiveness for creating deep relaxation, but stress reduction techniques such as progressive relaxation or similar will be very effective for most people. Meditation is good too. It might be worth buying a book on stress reduction or at least searching the internet. It's important to recognise that patience is a virtue here. In reducing anxiety generally, it is necessary to practice stress reduction and relaxation regularly. Don't make the mistake of doing it once, deciding that you don't feel any better generally and so give up believing it wont work. It will work. Remember, it's a cumulative effect, which over time, shows the subconscious mind that there is a state available to you where things are much safer than it currently believes them to be generally. As you work with this more and more, the subconscious mind becomes more and more familiar with the relaxed state which sends the message that life is becoming safe again and it begins to loosen its grip generally. The goal here is that you are working towards having your subconscious mind recognise that the danger is passed and that it is safe for you to resume intellectual control. If there is no danger present (overload of stress), then there is no reason to stay on Red Alert and therefore no need to remain anxious or depressed.

Now, since I am a hypnotherapist, I am naturally biased, but it should be noted that hypnosis is uniquely effective in this regard because the hypnotic state allows us to get in "underneath the radar". This means that ordinarily, the mind, especially the anxious mind is extremely untrusting of any messages coming in which do not match with its preconceived ideas of how things are. When a person is extremely relaxed however, the subconscious mind decides that the incoming data is from a safe source and may be considered. It is important to note here, that the incoming data is only considered, not automatically accepted. This is why it is not possible to absorb negative suggestions. The mind will automatically reject a suggestion if it cannot be used towards a more positive outcome than the picture it currently holds. Hypnotherapy does its best work when there is strong agreement at a conscious and unconscious level that the change being envisioned is strongly desired and can be realistically implemented. Then wonders can happen. If the subconscious mind decides that what you are presenting (in this case that it is safe to engage fully with life again) is a good idea and backs it, then you are pretty much assured success with your efforts. 

A good hypnotherapist will also have a number of highly effective tools available to deal with trauma. Obviously, some anxiety and depression results from trauma and it may be that there is difficulty with letting go for some people. Therapy is a good idea for anyone who is anxious or depressed. It can help enormously to have an impartial shoulder available who knows the territory. Do be aware though, that certain forms of therapy can actually be counter-productive. When choosing a therapist, please do recognise that any therapy which encourages continued negative introspection can actually make you feel worse! These styles of therapy are the ones where you go and tell your therapist all about your problems week after week and their role is simply to listen. This focuses on the problem, but doesn't offer solutions, and for reasons that should be obvious will often deepen anxiety or depression. Effective modern therapy should be positively focused, that is that it creates new perspectives and finds solutions to problems, hence the name- solution focused therapy. 

Taking care of yourself physically is obviously important. Good diet, a clean environment, regular exercise, and care with drugs of any kind is essential to overcoming anxiety or depression. Smoking and Caffeine (Coffee, Tea, Red Bull) are both powerful stimulants which increase anxiety and stress your nervous system. Remove them from your menu if you are able to (buy decaffeinated). Keep your alcohol consumption to a minimum. Alcohol affects your ability to produce a healthy flow of serotonin which is a key factor in our ability to cope and feel happy. You will note that depression is worse when we have a hangover, and it can take up to 3 or 4 days for our serotonin production to return to normal following a bad hangover. If you drink heavily twice a week therefore, you will not be giving yourself a chance to ever fully recover and we need sufficient serotonin to feel good. Long term therefore, it is important to recognise that excessive alcohol consumption will interfere with the therapeutic process and should be avoided as far as possible. By all means socialise, but do take care to note where your limits are. Everything in moderation. We also will note that moderate daily exercise can make a great deal of difference to the way you feel on many levels. It can improve your sense of self esteem, your sense of control, keep your weight steady and increase your serotonin and endorphin (feel good chemicals within your body) levels. The mental health charity MIND have published a free booklet on the benefits of exercise on emotional well-being which you can view by clicking here. 

In summary, to tackle anxiety and/or depression, it is necessary to:

· Remove as many of the major stressors in your life as it is within your power to do. 
· Learn to be kind to yourself. (Meeting your needs).
· Have faith that there is a way out of your difficulties even if that's not clear to you at present. It will become clearer as you make progress. 
· Challenge negative thinking as it arises. 
· Learn to relax deeply and practice this regularly. Self hypnosis will work well as will stress reduction techniques. Keep at it! Be patient and persistent.
· Seek professional help for any issues or traumas you feel unable to deal with alone.
· Look after yourself physically. Take regular moderate exercise. Avoid drugs of any kind (including caffeine and cigarettes) wherever possible.

I am a trained and certified anxiety disorders specialist with plenty of experience in helping people successfully overcome depression and anxiety. If you would like to meet me to discuss your difficulty and a way forwards please do feel free to make an appointment for a consultation.

John Crawford- DHP, HPD, MAPHP, MHS, MNCP - Registered Clinical Hypnotherapist - Written 3rd April 2004

Please feel free to copy this article. If you do reproduce this article in part or whole, it should be credited by an acknowledgment to myself and a link to my website: www.hypnotherapyforlife.co.uk