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By Bruce Campbell

People with CFS and FM often experience high levels of anxiety and worry, for very understandable reasons. The two conditions often create a loss of control over one's body and make it difficult to plan. They also bring uncertainty about the future, as people wonder if they will ever improve and whether any gains will last.

All those things applied to me, but I was able to reduce my anxiety greatly over a period of several years, thanks to using ideas I found in Edward Hallowell's book Worry. Using five of his strategies, I reduced my score on the worry scale in his book by 60% and, more importantly, changed the emotional climate of my life.    

Learning Mental Relaxation

Probably the most important change was learning how to create a state of mental relaxation.

Fairly early in my time with CFS, I began to take two daily rest breaks. The rests helped me to reduce my symptoms, increase my stamina and bring stability to my life. The physical relaxation was restorative, but sometimes the rests were stressful because my mind was racing, full of anxious and worried thoughts.  

In response, I  started experimenting with incorporating mental relaxation into the rest periods. I hoped that by quieting my mind, I could achieve a deeper quality of rest than by just lying down.

For the most part, I used a simple procedure that combined keeping my attention on my breath with the Relaxation Response, as described by Dr. Herbert Benson of Harvard. Benson suggests repeating a word or sound over and over for fifteen or twenty minutes. When your mind wanders, you return to your chosen word or sound.  

I found that using Benson's approach put me in a state of deep relaxation, in which I was aware of what was going on around me but detached from it at the same time. Benson describes this as a pleasant state similar to the feeling you might have lying on the beach on a warm summer day

Using the combination of Benson's directions and focusing on my breath allowed me to slip into a much deeper state of relaxation, in which I was aware of my surroundings and my thoughts but detached from them. Over time, I noticed that the calmness I experienced in my twice daily rests carried over into my daily life, reducing the "background worry," the ongoing anxiety that resulted from the long-term stress of living with a chronic condition.

Changing My Self-Talk

Relapses were a frequent and usually discouraging part of my life during my first two years with CFS. I often responded by "catastrophizing" or imagining the worst. As I lay in bed for hours and hours, I would say things like as "I'll never get better" or "It's hopeless."

These thoughts made me more anxious, frustrated and helpless, and created a vicious spiral. The negative thoughts intensified my worry. The worry made my symptoms worse, which in turn triggered another round of negative thoughts.

I was able to use the principles of cognitive therapy, which Hallowell outlines in his book, to interrupt this negative spiral. When I caught myself saying things like "you'll never get better" or "you'll be like this the rest of your life," I countered by telling myself "you've bounced back from all your previous setbacks, so just relax" or "remember how things always look hopeless when you're at your worst."

I'm convinced that speaking in a reassuring way to myself reduced the length of my relapses. Replacing my negative thoughts with positive and realistic ones enabled me to relax and thus gave my body more energy for healing.

Distraction and Immersion

When worry led to obsession with thoughts of bad things that might happen, another solution in addition to changing my thoughts was distraction and immersion. (Hallowell refers to this as changing your mental state by changing your physical state.)

If the worry level was fairly low, it might be dispelled by a minute or so of deep breathing. Breathing was relaxing and focusing my attention on my body distracted me from worry. Getting out of the house and taking a walk was another strategy.

Exercise relaxed me by stimulating endorphins while the visual stimulation distracted my thoughts. Another favorite was taking a nap. If my fatigue reached a high level, it was a sign that I was outside my energy envelope and all my symptoms were on "high," including brain fog, irritability and worry.

Other strategies that Hallowell suggests are listening to music, reading a book, praying, making a list or planning some activity, writing a letter and, in moderation, eating a snack. In sum, he says, "worry is a physical state of mind as well as a psychological one. One of the best ways to deal with worry is to change your physical state."

Talking with Others

Another strategy, connecting with others, also helped me to reduce my worry for several reasons. First, I relearned that basic truth that sharing a worry almost always reduces its size and emotional weight. Just giving verbal form to an anxiety seems to make it smaller. Also, talking with another person often led me to see my situation differently and consider  new options. Putting a worry into words translates it from the realm of imagination into something concrete and manageable.

Calling someone and hearing about their day was effective, too. By immersing myself in their world, I turned my attention away from myself and my worries. And the sense of connection helped reduce my anxiety.

Taking Action

Doing something to address the problem causing you to worry is another Hallowell strategy. That's a way to kill two birds with one stone. Taking action reduces or resolves an issue and thereby shrinks the reason to be worried.

One experience stands out, a serious relapse after some dental surgery. The dentist projected a one week recovery period, but two and even three weeks after the surgery my CFS symptoms were still much higher than before the surgery, leaving me worried that the procedure might have set back my recovery from CFS.

I responded with some reassurance, but also with action. Remembering that one of my rules for living with CFS was "If all else fails, go to bed," I increased my daily rest time to twice, three times, and eventually six times normal. After just two days of three hours rest, my relapse lifted.

Counseling & Medications

Although I didn't use either one, counseling and medications can be part of a worry management program. A counselor offers understanding, insight and options. Also, those who specialize in Cognitive Therapy can show you how to make your self-talk more realistic. And medications, while not a complete solution to problems of anxiety, may be one part of a comprehensive plan.

Related Articles

Reducing Symptoms with Planned Rest  
How to reduce symptoms and increase stability by using scheduled rest breaks.

Stress Reduction: Five Practical Techniques
Instructions for the Relaxation Response and four other relaxation procedures.

Taming Stressful Thoughts  
Describes the three step process for making your self-talk more realistic and more positive.