Anxiety is the most common form of mental health issue in the United States, overlapping significantly with substance use disorders. The National Epidemiological Survey on Alcohol and Related Conditions surveyed more than 43,000 people and found that nearly 18 percent of respondents who struggled with a substance use disorder in the past year also had an anxiety disorder.
There was an especially high correlation between substance use and generalized anxiety disorder and panic disorder. The survey did not include post-traumatic stress disorder, or PTSD, which some studies estimate affect as many as 50 percent of people with substance use disorders.
For many people with anxiety disorders, substance use is a way of managing symptoms. Alcohol is especially good for temporarily reducing anxiety, although the rebound effect often makes anxiety worse. Xanax and other benzodiazepines are commonly prescribed for anxiety and panic, but dependence can form quickly.
Anxiety is typically treated through psychotherapy, sometimes with the help of medication. During recovery, managing anxiety is especially important for preventing relapse.
If you struggle with anxiety, grounding can be a way of getting you through an anxiety or panic attack. Here are some easy grounding methods to help you manage anxiety.
The 5-4-3-2-1 Technique
The key to any grounding technique is to get yourself out of your head and into your immediate environment. The 5-4-3-2-1 technique helps you do this by engaging all of your senses in a systematic way.
Start by looking around and naming five things you see. It could be that clock on the wall, your water bottle, the traffic through the window, or watch the leaves rustling in the wind.
Next, notice four things you can feel. It could be a light breeze, the warmth of the sun, your weight on your feet, the clothes on you and so on. Take a moment to feel each of these things.
Next, close your eyes — if it’s safe — and listen to three distinct sounds, maybe cars passing in the distance, people talking in the next room, or birds chirping outside. Again, take a moment to experience each of these.
Next, identify two things you can smell. This one is typically more challenging since we are not used to using our sense of smell in a precise way, but this ambiguity can make it even more engaging. It might help to move your head a bit or smell items around you. Maybe you have a cup of coffee handy or maybe you can smell the fabric softener in your clothes.
Finally, focus on one thing you can taste. Maybe take a sip or bite of something and pay close attention to the flavors. Perhaps you can even still taste your toothpaste or the last thing you ate.
Deep Breathing
Deep breathing is an excellent grounding technique because it works on two levels. First, it’s a rich sensory experience.
You feel the air coming in through your nose, you feel it expanding your abdomen and rib cage, and you feel the warm air go out through your nose. You may also smell something as you breathe in. This sensory awareness can bring you into the present.
The second way deep breathing helps is that it physiologically helps calm you down. When you feel anxious, your sympathetic nervous system is overactive. This is the fight-or-flight system that is preparing to deal with a threat.
However, you can’t deal with anything if you’re panicking. The only way to reduce the activity of the sympathetic nervous system is to activate the countervailing parasympathetic nervous system, or the rest-and-digest system.
Taking a few slow, deep breaths does just that. In particular, a long, slow exhale stimulates the vagus nerve, which activates the parasympathetic system.
When you feel anxiety coming on, breathe in slowly for four seconds, hold it for about two seconds, and exhale slowly for six seconds. Be sure to breathe with your diaphragm so that your stomach expands slightly on the inhale.
Repeat this five or 10 times. The exact count doesn’t matter as long as it’s slow and regular and focuses on the exhale.
Body Scan
A body scan is a way to get out of your head and focus on physical sensations. Unless something feels especially good or especially bad, we tend to tune it out.
A body scan brings you into the present by acknowledging all the sensations we typically ignore. Start by closing your eyes — if it’s safe and convenient — and place your attention at the top of your head.
Notice anything you feel there: tension, itching, warmth, and so on. Then move down to your forehead and do the same thing. Don’t judge any of the sensations; just try to feel them as accurately as possible.
So, for example, if your nose itches, try to feel the exact point where it itches. If your jaw is tense, try to feel the outline of the tense areas.
Gradually work your way from the top of your head to the bottom of your feet. You may be surprised by what you notice.
Take a walk
If it’s convenient, a short walk is an excellent way to ground yourself. Moderate exercise increases blood flow to your brain and improves your mood by increasing your endorphins and reducing your reactivity to stress.
The changing environment gives you something new to focus on. A walk is especially good if you can be in a natural environment like a park. Many studies have shown that walking in nature reduces stress and anxiety even more than walking in an urban environment.
Counting
If you’re a bit more constrained, occupying your mind can be a quick way to get anxiety under control. There are a number of ways to do this.
For example, you might start counting upward by sevens or down from 100 by threes. You might try to remember the US presidents in order.
You might take a virtual walk around your childhood home or your hometown. Visualization is cognitively demanding, so anything you try to picture clearly is going to distract from your anxiety. Try to picture something pleasant in as much detail as you can.
Grounding is no substitute for therapy. If you struggle with an anxiety disorder, you may need to work with a professional therapist and you may need medication. First Responder Wellness uses trauma-informed strategies to address the unique needs of law enforcement, firefighters, paramedics, and other first responders with post-traumatic stress injury, substance use disorders, anxiety and depression.
Addiction does not have to mean the end of your career or a lifetime of struggling with your health and relationships. By taking a holistic approach to treatment and addressing the underlying causes of addiction, First Responder Wellness makes it possible for first responders to regain control of every aspect of their wellbeing. First Responders dedicate their lives to protecting their communities, and at First Responder Wellness, we believe in dedicating our time and expertise to helping these compassionate individuals find a path to lasting sobriety and mental wellness. If you or someone you love is struggling with addiction, call us now at 888-443-4898.
