Building up bit-by-bit
Break out of the cycle of anxiety by building up your activity level. Start with something small and build up bit-by-bit and slowly over time.
Everyone feels anxious at times. It is normal to feel anxious in scary situations, but it can become a problem when you start to feel anxious in lots of different situations and places, stopping you from doing things you want or need to do.
Having ongoing anxiety is common after a brain injury and when you have chronic pain. It can feel overwhelming and like you are trapped. Bigger problems start when you stop doing an activity because of these feelings, this leads to something called ‘fear avoidance’.
You become fearful of doing an activity because your brain sees it as a danger or threat, so you start to avoid or escape doing it. This eases your feelings in the moment, but in the long run it makes your anxiety grow, which means you do less over time. It can turn into a hard cycle to break.
This figures shows the cycle of fear avoidance – you notice danger, you avoid the situation, this gives a brief relief from anxiety but over time your anxiety grows.
Pain makes anxiety an even bigger problem. You might try doing activities that you fear will make your pain worse, such as going for a walk, going to the shops or seeing friends. When you start to do less over time, your confidence starts to reduce over time and your anxiety grows. Also, because you are not as active as you used to be, your body doesn’t have the strength to do the things you want to do, which then makes your pain worse and the cycle continues.
This figures shows the cycle of pain and fear avoidance – you notice danger, you avoid the situation, this gives a brief relief from anxiety but over time your anxiety and pain grows.
How do you stop this?
You can stop this cycle by building up your activity level slowly over time, starting with something small.
It is like training for a marathon. If you tried to run a marathon without doing any training, what do you think would happen? For most people, it would be too much and they most likely wouldn’t finish or injure themselves. So you need to start off small and build up slowly over time. For example, start with a small walk, then over time build up to running a few kilometres and then add one or two kilometres each week until you can confidently run the full distance.
Tackling anxiety works in the same way, you don’t want to try too much and flood yourself with feelings of anxiety and tension. You want to start small and build up slowly. This means you do things step-by-step (don’t skip a step) and keep going. This will help your confidence to grow.
It might feel pointless to start with such small steps, but focus on where you want to be and not on where you are now. Remember to be patient with yourself. Try not to compare what you can do now with what you could do before your injury. Every small bit counts, so keep chipping away at the bricks in your brick wall.
Read the Building bit-by-bit guide to help you understand how to tackle your anxiety and then use the My plan to manage anxiety to work on an issue you are feeling anxious about and learn to Be Pain Smart.