Imagine the anxiety as a gremlin. How does it look like? Try drawing or painting it or making a model of your gremlin. This can help you remember that you are NOT your anxiety. It is separate to you and under your control (like a pet!).

As any creature, when Anxiety Gremlin has access to food it grows bigger, and stronger, and has more control over your life, and after a while it feels impossible to get rid of him or her.

Copy of anxiety gremlin.jpg

As this model shows situations do not make us anxious. It is how we THINK about them. 

Can you guess what Anxiety Gremlin’s favourite food is? Yes, that’s right, it’s our thoughts. So, if we can slightly change the way we think about certain situations, there is a big chance for us not to experience overwhelming anxiety or experience much less of it. If Aisha did not think that something terrible is going to happen to her when she experienced shortness of breath she likely wouldn’t then feel anxious. Does it make sense? If so, can you try identifying a recent situation in your life when you felt anxious and analyse it?

The situation:

My thoughts:

My emotions:

My physical symptoms:

My behaviours:

Now, can you come up with alternative, realistic thoughts for this scenario? When you feel anxious you can come back to this method. Identify your thoughts and then create more realistic ones based on the evidence that you have. You should then see how your emotions change and physical symptoms go away. You can break it down like this:

Anxious feelings come from this thought:

Clues that disprove your anxious thought:

Realistic, more helpful thoughts:

To summarise then: if we think about a particular situation in a negative and out of proportion way, we feed our Anxiety Gremlin. The more we feed the gremlin, the more unpleasant physical symptoms we experience and the more likely it is that our behaviour will become unhelpful, and just before we know it, we are stuck in a cycle. But, if we can change our thoughts we can starve the Gremlin and show him or her, that we are in control of our lives.


1. RELAXATION

Another way to manage anxiety is to use relaxation techniques. Different techniques work differently for different people, so you just need to find one (or a couple) that works for you.

a) Your special place

In this method, you make yourself feel more pleasant and less worried by imagining a place that makes you feel happy, calm, and relaxed. It can be a place that you have been to, or one that it’s completely imaginary. You can do this exercise in your mind or on paper. Picture:

  • What you see – for example, a forest, a beach, sky, or a magical cotton candy land
  • What you hear – for example, the birds signing, marshmallow buses dropping of jelly customers at a busy shopping centre
  • What you feel – for example, the wind gently blowing on your face, the sun warming your hands, droplets of water on your body as you swim in the ocean
  • What you smell – for example, beautiful blossoming flower, a fluffy rabbit smelling of strawberries or the most caramelly caramel ice cream
  • What you taste – for example, salty water in your mouth, fresh orange juice or sticky cotton candy.

Remember, these places don’t have to be realistic at all. You can imagine whatever perfect scene you’d like. Keep thinking about it for a few minutes and feel your body relaxing and calming down.

b) A place you’re in

Sometimes you might not have time to imagine a beautiful, perfect place. In this case, you can focus on your surroundings and do the 5 – 4 – 3 – 2 – 1 exercise. List:

  • 5 things you can see
  • 4 things you can feel
  • 3 things you can hear
  • 2 things you can smell
  • 1 thing you can taste

This is a grounding technique. It helps you refocus your senses on the present moment and break the cycle of anxious thoughts. You can mix and match different senses and do it a couple of times in a row if you don’t feel less anxious after the first go.

c) Physical relaxation

This technique takes about 10 to 15 minutes. You can do it on your own, with a friend, a sibling, or an adult whom you like and enjoy spending time with. It is very useful if you feel constantly tense, wound-up, or worried. You’ll use a series of short exercises to tense all the major muscle groups in your body and then relax them.

Consider how the muscles feel when they are tense and how they feel when they are relaxed. Some parts of your body will be tenser than others, so try to locate the most tense areas. By the end of the session, you should be completely relaxed, so enjoy that feeling. Many people like to do these exercises before going to bed. It makes no difference if you fall asleep. The more you practise relaxing, the better and faster you will become at it.

This method is called progressive muscle relaxation and you can find a lot of videos online talking you through how to do it. Just search ‘’progressive muscle relaxation for kids / teenagers’’ in your browser and try different ones to see which one you like the most.

Some tips to help you enjoy this exercise even more:

  • Sit in a comfortable chair or lie on your bed
  • Choose a time when you will not be interrupted
  • Don’t overdo it. Tense your muscles just enough to notice what it feels like
  • It’s okay if it does not work the first time you try it. Just keep practicing and notice how you develop this skill over time
  • It’s okay if during the exercise you will notice some anxious thoughts. Just let them pass.

d) ​​​​​​​Get moving

Sometimes when you feel anxious you might not feel like exercising or playing sports. But we know that staying active is a very good way to dial down your anxiety and boost your mood. If you’re not sure what exercises or sports you can do with your condition, speak to your nurse or doctor. And, if for some reason, you cannot exercise it’s okay. Try using other techniques to calm your anxiety. There’s plenty to choose from.

​​​​​​​​​​​​​​2. BREATHING TECHNIQUES

There are times when you suddenly become tense or anxious, and you might not have time to go through relaxation techniques, on this occasion. Luckily, there are some simple tricks you can do while focusing on your breathing to help you feel calmer and more at ease. Breathing exercises help us slow down body’s natural responses to stress and anxiety, by slowing down the heart rate, lowering blood pressure and bringing us back to the present moment. And you can do them anywhere at any time.

a) Flower and a candle

Imagine that you have a nice smelling flower in one hand and a slow burning candle in another. Breathe in slowly through your nose as you smell the flower. Then, breathe out slowly through your mouth as you blow out the candle. You can repeat this 5, 10 or even 50 times until you feel a bit more relaxed.

b) Bunny breathing

Imagine that you are a bunny. Take 3 to 5, short, quick ‘’sniffs’’ through your nose. Exhale in one, long, smooth breath through your mouth.

c) 4 – 5 – 6 breathing

Breathe in slowly through your nose to the count of 4. Then, hold your breath for five seconds. Then, slowly breathe out through your mouth to the count of 6. Repeat three to five times, or until you feel calmer.

If this is not working for you, try to modify this method to 3 – 4 – 5 instead and notice what feels better.

d) One nostril breathing

This is a silly, fun exercise. Place your finger over one nostril then breathe in deeply. Next, switch your finger to the other nostril and breathe out. Once you have exhaled slowly, switch and repeat. Repeat up to 5 rounds.

e) Five finger breathing

Five finger breathing helps to slow down your breathing. Stretch out your hand like a star. With your other hand, put your finger at the base of your thumb, and slowly slide up to the tip of your thumb. As you slide up, take a deep breath in. At the tip - pause briefly. Then running your finger down the inside of your thumb breath out slowly and gently. Then slide all the way up to your index finger tip whilst breathing in deeply and slowly. Then at the tip of your index finger pause, and as you slide down the inside of your index finger, gently and slowly breath out. Do this gently and slowly for all 5 fingers to help get control of your breathing again. Repeat as needed, gently and slowly.

 

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​​​​​​​3. MINDFULLNESS

Being mindful simply means being in the here and now. When we are fully present, we don’t spend so much time expecting things to go wrong or expecting that we won’t be able to cope with things, or just worrying about what other people think about us. To be in the here and now you need pay attention to what you are doing or what is happening around you almost as if you had a camera with big zoom lens.

When you brush your teeth pay attention to how toothpaste tastes like and what is its texture. Look at your water taps. How do they look like? What is the water’s temperature as you rinse your mouth? What sounds do you make when you rinse your mouth? Did you spill any water on the floor? If so, where? What is its shape now?

You can focus on any activity like this, whether you are taking a shower, walking to school, listening to music, or eating breakfast. You can also focus on objects. Notice their shape, size, texture, colour and how do they feel when you touch them.

 

4. STEPPING BACK FROM YOUR THOUGHTS

You can learn by being less bothered by your thoughts if you try to accept them for what they are – passing thoughts. Just let them come and go. Notice how as one thought passes another one arrives. Just because you have anxious thoughts does not mean they are true. When you have anxious thoughts say to yourself ‘’A thought is just a thought, not a reality’’.

a) Thought stopping

As soon as you notice an unhelpful thought say ‘’STOP’’ very loudly or imagine a red, bright stop sign in your mind. Then, challenge this though, cope up with an alternative one and say the new thought out loud.

b) Distraction

Anxious or negative thoughts are becoming lounder and more overwhelming if we keep listening to them, so having distraction techniques can be helpful when you’re in a panicked or worried state. There isn’t one technique that will work for everyone, but here are some examples:

  • Listening to your favourite song
  • Naming every rectangular object, you can see.
  • Naming every yellow object, you can see.
  • Colouring or drawing.
  • Reading a book.
  • Spelling the name of objects you can see, and then spelling them backwards if you can.
  • Counting backwards from 10, 20 or 50.

You can be very creative with your distraction techniques. The idea is to simply learn to refocus your attention rather than listening to unhelpful thoughts.

Now you have all the tools and techniques a detective needs to challenge, test and restructure their thoughts and manage their anxiety. Remember to practice them regularly for the best results!

ONLINE APPS

Here are some mobile apps to help you manage your anxiety

  • Breathe, Think, Do with Sesame
  • Mekorma
  • Smiling Mind
  • DreamyKid
  • Calm

You can also search for free meditations for children online.

For further assistance, please contact our Paediatric Psychology Team via dgn-tr.paediatricpsychology@nhs.net