Note:  This post is quite different from my typical posts and was inspired by the media coverage on Whitney Houston’s death.

As a specialist in anxiety, I am all too familiar with Xanax, one of the prescription drugs that Whitney was prescribed.  Xanax is benzodiazepine,  a class of drugs known to be highly addictive.  Xanax is one of the worst “benzos” because it is fast acting and sedating.  It calms anxiety within minutes – unfortunately the benefits are short term and actually negatively reinforce anxiety (see my post Working Past Panic) often making it worse in the long run and thereby requiring more medication to calm the anxiety. It is physically and psychologically addictive and there is a tolerance effect such that people often need more and more to get the same effect.

The media talked a great deal about how Xanax can be dangerous when mixed with alcohol.  However, I’ve heard very little about the fact that her physician prescribed a highly addictive drug to an addict. Just because a drug can be prescribed, doesn’t mean that it is safe and that it isn’t addictive. Much like alcohol – just because it’s legal, doesn’t mean it isn’t addictive.  We would all gasp if a doctor advised a patient to use alcohol to calm their nerves.  We would gasp even louder if the patient were an addict.  In my opinion, if you wouldn’t prescribe heroine to an addict, you shouldn’t prescribe Xanax either. Regardless of whether Xanax contributed to Whitney’s death or not, the prescribing physician was irresponsible (and my guess is it did play a role – even if it was a springboard to using more illicit drugs).  Xanax is used for anxiety and cognitive-behavioral therapy has been proven to be more effective in treating anxiety disorders than any medication. Nonetheless, SSRIs and other medications that are not addictive can be effective in treating anxiety.  Furthermore, exercise, chiropractic, herbs etc. can be very helpful as well. So if one chooses to not engage in therapy – there are better alternatives than giving Xanax to an addict.

Jennifer L. Abel, Ph.D.
author of Active Relaxation: How to Increase Productivity and Achieve Balance by Decreasing Stress and Anxiety.

Don’t Fall Prey to The Abstinence Violation Effect (AVE)

AVE is when you make a slip and then completely abandon a goal. So for instance, you quit smoking having puffed your last fag at 11:58 on New Year’s Eve and manage to keep from smoking until February 10th. On that date, you go out with a friend who smokes and you have a couple drinks. He smokes the same brand and it looks so good. Your defenses are down and that chemical reaction from the alcohol makes you crave it all the more, so you smoke. As you take those last couple drags you think, “I’ve blown it. I’m a failure and I’m doomed to smoke for the rest of my life” and you immediately go back to the pack a day plus habit.

To avoid falling prey to the AVE, distinguish between a lapse and a relapse. A lapse is a slip and should be considered temporary and human. A relapse is more than a slip. It’s a fall because it is followed by a decision to go back to your old habits, abandoning hope to succeed at your goal. Remember that a lapse does not need to become a relapse.

If you have sworn to only eat sweets on the weekends and you eat a brownie on a Tuesday night, don’t eat 2 more and give up the goal. Tell yourself something like this: “I’ve done really well up until this point and I’m going to continue to do well from here on out. I’m human and had a temporary lapse. I’m not going to relapse. Instead I’m going right back to keeping the resolution.”

Tweak Your Goal if Needed

If you decide that you can’t or don’t want to meet your resolution because it’s just too difficult, rather than abandoning the goal, change it. So, for instance, let’s say that you decide you are going to keep to a budget of $400/month for everything except your rent, utilities, car expenses, and groceries. Then in the last week of the first month you feel you have been pretty good, but have to pass up social plans or a good buy on some shoes and you start to feel frustrated and deprived. Rather than giving up the idea of a budget, loosen it. Maybe $125/week is more reasonable. (Tweaking a goal is not typically recommended for addictions.)

Want vs. Need

We are generally more motivated to do something that we “want to do” rather than something we feel like we “need to do.” So rather than telling yourself that you need to lose weight or you need to go to the gym, think “I want to be thinner” or “I want to get into good shape and I want to feel that sense of well-being after a good workout.”

For continued support w/quick tips to keep your resolution – “LIKE” my FB Active Relaxation Page in the side bar to your right.

Best of Luck with your New Year’s Resolutions and have a Very Happy New Year!
Jennifer
Jennifer L. Abel, Ph.D. author of “Active Relaxation“

10 Facts:
1. Medication is more effective than behavioral strategies for about two weeks.
2. Stimulus control, progressive muscle relaxation, and other behavioral strategies are more effective than medication in the long run. These methods may start to work in a couple of days, but take about two weeks to reach their maximum effectiveness.
3. Taking a pill is much easier than learning useful strategies and developing new habits. Duh!
4. Often, people gain a tolerance to these pills requiring a higher dose to fall asleep.
5. Hangovers from sleeping pills are not uncommon.
6. Progressive Muscle Relaxation decreases sleep onset time by an average of 60% in insomniacs.
7. Medication works best when used on a time-limited basis or infrequently. Sometimes just knowing it’s an option can help people to sleep….however….
8. People can develop both a psychological addiction, as well as a physical addiction, to these medications.
9. Some people sleep well with natural alternatives to sleeping pills such as Melatonin, Kava Kava, or Valerian Root. Check with your physician before using them.
10. Daily exercise helps sleep as long as it is completed more than 2 hours prior to bedtime.

In general, use your bed for sleep and only for sleep (except sexual activity). Do not balance your checkbook, watch movies, or have conversations in your bed. Don’t go to bed until you are sleepy. If you find yourself worrying about not being able to sleep, can tell that you won’t fall asleep soon, or have noticed that you have been awake without sleeping for a longer period of time than it takes you to fall asleep on a good night, get out of bed and do something relaxing elsewhere. If you are worrying about forgetting something the next day start a list of things to do – but do it OUT of bed. If the thing that you are worrying about could be done then and you think it will help you to sleep, do it, particularly if it takes 30 min or less. Then follow that with something relaxing.
EXCEPTIONS – some experts believe that it is useful to read in bed, but only IF you find the reading material relaxing. If you get anxious every time you get into bed, finding a relaxing activity to do in bed might actually help you to sleep. Reading with a dim light directed on the page, not overhead, is usually best. Bright lights and light from a TV or computer can inhibit the release of melatonin which is necessary for sleep onset.
ALSO, if you get anxious when you get into bed, you may want to try sleeping on the couch or in an extra bedroom. If you find you sleep well in the new place, you probably have a stimulus control problem in which your bed has become a trigger for anxiety and wakefulness. As your problem lessens, begin sleeping in your bed more and more.

Jennifer L. Abel, Ph.D.
author of Active Relaxation: How to Increase Productivity and Achieve Balance by Decreasing Stress and Anxiety.

Given that we feel more vulnerable, and therefore more anxious, about our worries after tucked into bed (see previous post) consider addressing the issues you are likely to worry about while you are still up and about. Around 30 min to 2 hours before you go to bed make two columns on a sheet. Under the first column write down what you think you will worry about that night.

In the second column write down what you are going to do about it before you get into bed. In the second column you could write a) “nothing,” b) a specific thing that you are going to do before you go to bed, or c) a plan to do something later. Even when deciding to do nothing, writing it down and thinking about it is giving the worry due diligence. In other words, you have addressed it by thinking about your options before deciding to do nothing about it before bed. When planning to do something, be sure to schedule that plan, or at least write it down somewhere that will allow you to remember.

by Dr. Jennifer L. Abel

author of: Active Relaxation: How to Increase your Productivity and Achieve Balance by Decreasing Stress and Anxiety.

Most people worry because they are trying to increase the likelihood that good things will happen and decrease the likelihood that bad things will happen. Yet, worry does the opposite. Obviously, it leads to useless anxiety and that’s a bad thing. Research by Michel Dugas and his colleagues found that worriers have the ability to problem solve as well as their more relaxed peers. However, anxious people tend to have myopic vision when faced with problems. In other words, their mental focus is limited to the extent that they miss options that might help them to solve their problems better.

Likewise, think about when you have your best ideas and creative insights. How often do they occur when you’re really stressed? If you’re like most people, your best ideas come when you’re relaxed and often when you’re not even trying to find a solution. So, first de-stress, then fix your mess.

Jennifer L. Abel, Ph.D.
author of “Active Relaxation: How to Increase Productivity and Achieve Balance by Decreasing Stress and Anxiety.”

Have you noticed yourself and others overusing the word “hate.” Be mindful of how often you use this word and whether it’s really accurate. I believe that we feel what we say, even when we don’t really mean what we say. When you say that you “hate” something or someone when the reality is that you “dislike it,” you may be feeling unnecessary anger or unrest. If there is someone that you are having difficulty forgiving – think about using “dislike” instead of “hate” to think about them. It may also be helpful to think about something you like about them.

On a personal note, I have made an effort over the past few years to reserve the word “hate” for things that I really loathe. I have probably cut the use of it by more than half and I do think it has had a positive impact on my life.
Peace out!

Jennifer L. Abel, Ph.D.
author of the book: Active Relaxation, How to Increase Productivity and Achieve Balance by Decreasing Stress and Anxiety.


Okay, yes! There are certainly somedays that seem like everything has gone wrong and you think “this is a BAD DAY.” But, this is not accurate. Even on days that many trying things happen there are also many things that go right. Little things that you take for granted like your car started – that you have clean clothes – that you have running water – your watch didn’t stop, etc. When you feel like your day is bad, you stop seeing the good in it and will miss positive things. Consider the following:
1. If you didn’t have difficult days, you wouldn’t appreciate the easier and better ones as much.
2. You probably learn more from the difficult days than from the easy ones.
3. When you are having “one of those days” Do something nice for yourself or even better, do something nice for someone else. Maybe do both!
4. Sometimes things that first seem bad, end up being great. Like the people who met when they got into a car wreck and ended up getting married. Or like my friend who lost his job and ended up getting a job he liked much better that is way closer to home.
5. When you feel like you’re having a bad day – look at how many hours you have left for it to change.
6. Look forward to tomorrow being a better day.
7. The Serenity Prayer – especially “accept the things you cannot change.” (courage to change is in #5)
8. As suggested earlier, start making a list of all of the things that could have gone wrong and didn’t.
9. Similarly – think about 5 things for which you’re thankful.
10. Create your own! Feel free to share it.

By Jennifer L. Abel, Ph.D.
author of Active Relaxation: How to Increase Productivity and Achieve Balance by Decreasing Stress and Anxiety

instead of what you don’t want. I was at a pool yesterday and was impressed when a father said firmly, without yelling “walk” when his boys were running. And they did exactly that. I’m so accustomed to hearing parents shouting “DON’T RUN!”

When you tell someone to “not do something” they think about what it is you want them to “not do,” instead of thinking about what it is that you want them to do. This is particularly important in parenting, because children usually want to do what they are told not to do. Although in this case it is pretty obvious to a child that the parent wants him or her to walk when shouting “don’t run” in many other cases it may not be apparent.

Another example of this that I remember is when my cousin was trying to teach a friend how to ski. He kept telling them “don’t pull your arms in.” I retorted “keep your arms straight.” Not only was I telling them the right thing to do, it’s not critical and it’s more encouraging and positive.

by Jennifer L. Abel, Ph.D.
author of Active Relaxation: How to Increase Productivity and Achieve Balance by Decreasing Stress and Anxiety
www.activerelaxationthebook.com

Anxiety and Stress occur in a spiral of interactions between thoughts, images, physical sensations, behaviors, and emotions. Not everyone experiences all five, but everyone does experience a similar pattern each time they spiral. Relaxation, Better But Believable Thoughts (see my post dated Feb 3), and most coping strategies are useless once your spiral has gained momentum. In fact, researchers at Penn State found that coping strategies did little more than talk therapy to alleviate worry and anxiety. In a follow up study, they taught anxious individuals to prevent their worry spirals from getting out of control by catching them early and found that most all were able to successfully reduce anxiety and worry substantially and enjoy a more relaxed life.

I suggest that you use mindfulness and other relaxation strategies I’ve covered in previous posts several times/day. Use post-it notes or other reminders because we typically don’t recognize stress until it has gained some momentum. Use the strategies without stopping your flow of activity. So for instance, you can feel the surfaces beneath you and continue to read this post, make phone calls, type, or engage in just about any activity.

Check back soon for other ideas on how to nip your anxiety in the bud.

Dr. Jennifer L. Abel
author of: Active Relaxation: How to Increase your Productivity and Achieve Balance by Decreasing Stress and Anxiety.
www.activerelaxationthebook.com

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