I had a heart attack a few years ago, which led me to struggle with anxiety and depression. Since then, I have spent a good deal of time and effort building up coping strategies. This included working with mental health care professionals.
My panic attacks can be triggered by the mere thought that I am having a symptom of a heart attack, and it may take hours, sometimes even days, to regain my equilibrium. That’s my normal.
But with the global pandemic burning through the world right now, destroying lives and livelihoods in its wake, nothing is normal.
Panic, it seems, has found us all.
This post is about the skills and tools I’ve built up to manage my own cardiac anxiety which I am using now to navigate a truly global disaster.
Identifying and managing disaster thinking
There was a moment when I was in the hospital with chest pains, the day before my heart attack when I was in denial that anything was wrong. I remember talking to a nurse about my plans for the next day and through the week at work and she stopped, looked me in the eye and said: “You are looking way too far ahead right now.”
She meant for me to focus on the immediacy of not just the situation I found myself in, but to scope my world view to a single 24 hour period. That was my first lesson in changing my perspective. One that lead me to later understand the concept of disaster thinking and how to walk away from it.
Disaster thinking is when you fully expect the worst possible outcome to come to light. It feels like something inevitable, that can’t be escaped. But when you scope your time to smaller increments and use inversion, you can begin to pull away from it gradually.
What that looks like for me, again, is scoping my routine to a single day. Using my routine, I can move from hour to hour knowing what comes next. This helps with the uncertainty of what a disaster would actually present.
Inversion is something you do when you hear a statistic, like “People who have had a heart attack are at a 25% higher risk of a second event.” Inverting it means 75% don’t. It’s choosing to take a “what can go right” view of your world by actively envisioning it.
The following items are in my toolbox to manage disaster thinking and focus on the here and now:
This does not have to be anything heroic or gladiator-style. All you need to do is follow the guidelines like taking a walk every day, doing X number of steps or climbing stairs. For me it’s running, lifting some dumbbells, riding my exercise bike and getting a yoga session in every week.
Now, this was something I really struggled with. I used to be a traditional guy – not someone warm and cuddly... Meditation just seemed, well, too soft. But I read it can help with survival in addition to reducing anxiety. I now do this every day. Sitting on the floor, or where ever really, listening to my breath, letting my brain go haywire, but always coming back to the breath. That’s the practice of meditation for me. Over time it has helped me to take my focus off of the raging fire and onto calmer scenarios.
Reaching out to friends
Again, this was not one of my fortes in the past. But working with a therapist over the past five years has helped me with this. I had to learn how to become vulnerable and open – not only with my other male friends but with female ones as well.
I found that some of my friendships had withered from neglect. It took time to grow them back to health but it was fully worth it. In the era of the pandemic, this has been a true lifeline for me in isolation. The good news here is that all you have to do is pick up the phone and reach out to someone. Listen to what they have to say with compassion and empathy and honesty. That’s all it takes. Just as with meditation, we tend to get better at this over time.
Asking for help
This is another tough one, but completely worth it. Even now, there are options for online counselling out there. Some are free. Others are not. Regardless, having the courage to admit you need help is one of the best things you can do for your overall health. When I started working with my first doctor I had to get comfortable about talking about my emotions and being open with my feelings. I didn’t want to at first, but over time it got easier. Now, instead of bottling things up, I am more prone to talk with someone than I used to be. It helps.
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Scoping everything to a single day
I spoke about this one earlier. I do this by narrowing my focus on my routine. At one point I even went so far as to make a schedule for myself with markers on my calendar. It helps when your brain is overwhelmed. I was experiencing pure uncertainty after being released from the hospital after my heart attack. My whole life changed in two weeks.
The same principle of scoping your focus on the here and now works for times like these. Your routine might include things like getting up, showering, making coffee, getting dressed, reading emails and so on… Just keep doing that. Do it with focus. It will help to give you a sense of continuity and normalcy even when you find yourself in alien territory.
This is another thing that sounds simple but, when you bolt awake in the middle of the night in fear of having chest pains, being unemployed or getting sick, well, that’s when it gets difficult.
I usually do my meditation before bed to slow down my breathing and heart rate. It helps set the mood so to speak. I also don’t bring my phone to bed, or use my computer after 9 p.m. to reduce the exposure to blue light which allegedly wreaks havoc on our ability to sleep.
Again, it’s a combination of little things set up in the form of a routine that helps you to gradually improve the quality of your life. I used to sleep between four and five hours a night. Now my watch tells me that I am averaging between seven and eight hours a night with a good balance between deep, light and REM sleep. I also found that my heart rate lowered as my sleep health improved.
We owe it to ourselves not to give up hope. Whether it’s after a heart attack or during a global disaster. We can choose to allow things to overwhelm us or we can choose to take control back. To take ownership of our lives so to speak. Is it hard work? It can be. Is it worth it? Most definitely.
Find what works for you by analysing your life in terms of a single day. Keep your routine and your balance. Start small and make changes only as you have the capacity to do so. There is no rush in any of this. Over time, you will feel more grounded, as I have, and life will resume with less fear and more fulfilment.
Good luck everyone. Even in the darkest hours, don’t give up hope.
UK/MED/20/0135 April 2020