Where the Science of Psychology Meets the Art of Being Human

Managing Anxiety: 8 Proven Ways

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Managing Anxiety: 8 Proven Ways

Exams, traffic, an argument or a deadline are all enough to trigger a ‘fight or flight’ response, sending stress hormones and adrenalin surging through our body. Sometimes, the body’s fight or flight response can be supersensitive, pressing go on the surge when there’s no real threat. The message to surge comes from the amygdala, a part of the brain that’s been in charge of fight or flight for thousands of years. It’s brilliant at its job, but sometimes it works a little too hard.

Managing Anxiety: The First Thing You Need to Know

When there’s no actual threat, there’s no need for fight or flight. That means there’s no need to expend the oxygen and energy that your body has been provided with. If you’re able to do some sort of physical exercise to metabolise these hormones, brilliant – but this won’t always be possible. Every physical symptom of anxiety is caused by the build-up of these chemicals in the body.  

The Relaxation Response

The amygdala has had millions of years more practice at initiating the fight or flight response than we’ve had at stopping it, so generally, just trying to lay a convincing argument that there’s nothing to worry about won’t work. We need to convince the same brain that’s so heroically swung into action to protect us with the fight or flight response, to cool its jets because we’re fine – there’s no need to fight and no need to flee.

The relaxation response was designed beautifully by nature specifically for this task. Its existence was discovered by Harvard cardiologist Dr Herbert Benson.

The best thing about the relaxation response is that, like the fight or flight response, it’s also hardwired in the human brain. Being hardwired, there’s no need to believe the relaxation response will work – it just does. It’s automatic, just as the fight or flight response is automatic, regardless of whether we actually need it or not.

When triggered the relaxation response automatically and instantly sends out neurochemicals that neutralise the fight or flight response.

The relaxation response will decrease blood pressure, lower heart rate, lower pulse rate, reduce the oxygen in the bloodstream and increase alpha brain waves (these are associated with relaxation.

A Relaxation Response – How Do I Get One?

Being a physiological response, there are many ways to elicit the relaxation response. Experiment with the different ways to see which works best for you.

Remember, your fight or flight response has been doing its thing uninterrupted for a while so illiciting a relaxation response may take a bit of practice, but you will get there and the results will be worth it. Now for the how …

  1. Control your breathing. (Yes. I know you’ve heard it all before, but stay with me.)

    When your breathing is under control, the physical symptoms that are associated with shallow rapid breathing, an oversupply of oxygen and increased heart rate, will reverse. There are a few ways to do this:

    1. Sit quietly.
      Breathe in through your nose to the count of three, ‘In, two, three.’
      Breathe out through your nose to the count of three, ‘Relax, two, three.’
      Repeat until your breathing is under control.

    2. Make yourself aware of your breathing.
      Put one hand on your chest and one hand on your stomach.
      Breathe in so that your stomach rises.
      Hold your breath briefly.
      Breathe out slowly, thinking ‘relax’ and feeling your stomach fall.
      Try to make sure that the hand on your chest doesn’t move very much.
      Repeat 5 to 10 times, concentrating on breathing deeply and slowly.
      Practice in advance – even on the good days – so you’ll have it when you need it.
    3. Try to slow your breathing down
      Do this by taking a short pause between when you breathe out and when you breathe in.
  2. Exercise.

     Physical activity turns down an overactive fight or flight response by metabolising excessive stress hormones and returning the body back to calm.

    Remember, the fight or flight response always intends for itself to end in vigorous physical activity – either fighting or fleeing the danger. 

    Running up and down stairs, sit ups, a quick run or fast walk – anything sweaty – is enough to bring the fight or flight response to its natural conclusion. This isn’t always possible, but exercise also has a protective function. 

    An abundance of research has shown that getting sweaty five times a week, for five minutes a stint – even if it’s not during an anxiety attack, will make people less anxious, stressed and depressed. That’s all it takes – five minutes. If hot and sweaty isn’t your thing, a 20-30 minute brisk walk five times a week is just as good. (In fact, it’s that good, it has the same effect on the brain as antidepressants.)

    The benefit of exercise on mental health is a given. It’s been the subject of extensive research and has proved it’s point over and over.

  3. Know what your symptoms are not.

    Know that you are not having a heart attack. Heart attacks are likely to come with shortness of breath, pain or discomfort in the centre of the chest, as well as jaw pain, pain in one or both arms or another part of the upper body, generally on the left side.

    Know that you are not going crazy. The very fact that you are able to question whether or not you’re going crazy means that you aren’t. People who have lost touch with reality lack insight and don’t have the ability to question or worry about their mental state.

  4. Don’t fight it.

    Anxiety feeds off itself until after while, you get anxious about being anxious. The more you struggle against it, the more it will stay. It thinks it’s there to protect you, remember. The more you can accept your anxiety and assure yourself that it’s there to look after you, the quicker your anxiety will fade.

    Remember that your anxiety is a physical, neurological response of an over-vigilant brain. Remind yourself of this to cue the breathing techniques that will calm your physical symptoms.

  5. Progressive muscle relaxation.

    This can take a while to get used to, so if you can, practice every day, maybe before sleep to send to some much-loved zzz’s your way. Basically, it’s progressively relaxing tensing and relaxing the muscles from your toes to your head. Start with your toes – tense for a couple of seconds, then relax. Then, move to your feet – tense, relax. Then work your way up to your head. Here is a specific breakdown but you don’t need to follow it exactly. The main thing is to start with your feet and work your way up.

    • Get comfortable.
    • Starting with your foot (left or right, it doesn’t matter), tense your feet muscles as hard you can while breathing in. Count to ten with your muscle still tense. Suddenly and quickly, release the muscles to they are completely relaxed. Count to twenty. Repeat using the same foot.
    • Repeat with other muscles, working up one by one to your face. Right foot – pull your toes up, tense, relax.
    • Left foot.
    • Right lower leg (calf).
    • Left lower leg (calf).
    • Right thigh.
    • Left thigh.
    • Buttocks.
    • Tummy.
    • Left hand – clench your fists, relax, repeat.
    • Right hand.
    • Left Forearms – tense your bicep, hold, relax, repeat.
    • Right forearm.
    • Chest – breathe in as deeply as you can, hold, relax, repeat.
    • Back – arch your back, hold, relax, repeat.
    • Neck – pull your chin to your chest, hold, relax, repeat.
    • Jaw – clench tightly, hold, relax;
    • Face.
    • Tongue – push your tongue firmly against the roof of your mouth, hold, relax, repeat.
    • Eyes – close tightly, hold, relax, repeat.
    • When you’ve finished, count slowly backwards from five.
  6. Mindfulness.

    Mindfulness. If the very word invokes the smell of incense and lentils and the vision of Skye Liberty Rain and friends astral projecting under a dreamcatcher then you need to know this:

    Harvard Medical School is on board, describing mindfulness as a powerful therapeutic tool. One of the ways it works is by improving connections in the brain. See their research here.

    Research has shown that it can ease stress and help to alleviate depression and anxiety, improve sleep, mood and memory, facilitate learning, improve breathing, reduce heart rate and improve immunity. Mindfulness can also clear the mind, slow down anxious thoughts, slow down the nervous system, improve concentration and bring about relaxation.

    The practice of mindfulness has its roots in Buddhism. It’s a powerful way to elicit the relaxation response and involves observing or noticing what’s happening now, in each unfolding moment, without judgement. In short, it’s the opposite of multitasking.

    Now the how:

    • Centre. Close your eyes and notice your body. Focus on your breathing. How does the air feels as you draw it inside you? Notice the sensation of the air, or your belly rising and falling. Notice your heart beating.
    • Broaden. Once you’ve narrowed your concentration to what you’re feeling inside, start to broaden your focus. What can you hear? Feel? What ideas come to you? Consider each without judging or analysing. If your mind starts to wander, focus again on your breathing.
    • Observe. Watch what enters and leaves your mind and find out which thoughts contribute to your struggle and which contribute to your feelings of happiness. Try not to fix on any one idea, emotion or sensation. Similarly, try not to get caught up in thinking about the past or the future.
    • Stay with it. Aim for 20 to 40 minutes of mindfulness practice a few times a week. If this sounds like a lot, start slowly and build gradually. Mindfulness can be as easy as learning to pay attention to what’s happening around you – listening to music, walking, but really focussing on the experience. The results will be worth it.

    It’s normal with anxiety to search frantically for the reasons behind the symptoms in an attempt to ‘solve’ whatever problem is causing the trouble. Because anxiety is often triggered falsely, without a real problem, trying to identify the source is fruitless, yet the anxiety continues.

    Numbers 7. (‘Turn it Off) and 8. (Worry Well, but Only Once) will help with this.

  7. Turn it off.

    The idea behind this is to give your mind a break from worrying over and over about the same things or about nothing in particular.

    • Sit quietly and close your eyes.
    • Imagine a box that’s open and ready to receive every worry on your mind.
    • See each issue, name it and put it in the box.
    • When there are no more issues that come to mind, close the box and imagine putting it somewhere out of the way, maybe a shelf or a cupboard or under the bed, until you need to go back to retrieve something out of it.
    • Once you have put the box away let the space that’s left in your mind be occupied with whatever is feeling or thought is most current to you.
  8. Worry well, but only once.

    Sometimes the only way through something is straight through the middle. Worrying about something in such a way as to give it full attention can help to stop it playing over and over in your mind.

    Give yourself a time limit of 10-20 minutes and worry through all of the issues that are bothering you.

    Set a time to worry about them again. If they pop up again in the meantime, remind yourself that you’ve already worried about them and that you’ve set a time to come back. Then, quickly divert your attention and thoughts to another activity. It might be helpful to have a ready made list of possible diversions.

And Finally …

You can’t learn to swim in a swollen sea.

Practice these techniques during quiet times when you aren’t feeling anxious. Every time you do, you’ll get better at it.

Your anxious mind will stop giving your body the ‘ready-set-go’ shove, and both of them will thank you.

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40 Comments

Lloyd Golden

Just searched your webpage as I was looking for articles on ‘anxiety’ as I’m having issues with my 13 year old son suddenly not wanting to go to school. It’s been over a month now and we’ve ruled out bullying and possible threats. We’ve had him to doctors and they’ve found nothing physically wrong with him. They diagnosed him with generalized anxiety disorder and want to put him on Prozac. I am so against this. I found your article very helpful and will start applying your suggestions to help my son. I will definitely let you know the outcome in a few weeks. Thanks for your very helpful suggestions.

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heysigmund

You’re very welcome. There are some very effective medications out there but I am of the opinion that it should be an option further down the track than the first first one, and always used in conjunction with some form of counselling. Even in the responses to this post, there are so many people with kids around the age of 12 or 13 who are struggling with some form of anxiety. I’m so pleased the information has helped you. Assure your son that he’s not alone. There are so many kids struggling with anxiety just like he is. I hope he is able to find some relief. I would really love to hear how you go.

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Lisa

We went through the same things with our son starting at age 8. Couldn’t get him to school, always saying he didn’t feel well. Our doctor performed every test imaginable to rule out any illness. In the end he was diagnosed with anxiety. Our doctor suggested medication as a very last resort, which was also our way of thinking as we were for trying all other options first.
We started sessions with a child psychologist. Our son has always been very articulate and the therapist caught on quickly to this and she decided to do some testing of hisIQ. Turns out he was in a very high percentile for his Perceptual reasoning and Verbal comprehension but his Working memory and Processing speeds were well below even average, this she felt was most likely causing him conflict and anxiety when going to school. The school did more testing to help confirm what she was thinking. After this the therapist sent a report to the school stating he would need to be in the Individual Education Plan…my son now has a laptop at the school to do work on and he has one on one time each day to help him understand any work that is not clear.
Once that started in grade 4 (he’s now in grade 6) his anxiety decreased immensely! He had so much more confidence. I have spoken to a number of other parents whose sons have gone through the same things.
Our son still deals with anxiety on a daily basis but to a much lighter degree. What was a 10+ for his anxiety levels is now I would say a 3 most of the time. I use to have to drag him to school with both of us crying (we didn’t want him to think staying home was the answer) and once he was handed off to the teacher they would tell me he was much calmer. I think it was the initial anxiety of working himself up before going. Now it is so wonderful to see him hop out of the car with a smile (90% of the time) and say “bye mom, see you after school”.
We use a homeopathic remedy called CALM by the 0-9 Brand to help him relax when he gets worked up and lavender lotions and oils before bedtime. As well as breathing techniques.
I found the hey sigmund article even more enlightening to the subject. It has helped clarify the actual struggle that the children go through in a way that has allowed me understand my son even more. Thanks Karen for publishing it. I actually cried while reading it.

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heysigmund

Thank you for sharing this! I’m so pleased your son has found his way through. It must be such an enormous relief for you. Your experience will provide hope to others who are in the midst of the struggle. Thank you!

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Jackie

Lloyd, Have you tried googling the terms “school refusal”? I found a whole wealth of information online about this issue when my son started experiencing severe anxiety related to going into school. Cognitive behavioral therapy with a psychologist might be helpful – it was for us. Also, working with school staff to arrange for accommodations in the school environment also helped. My recollection is that school refusal often happens at transition ages (like 13), when kids are changing schools. Good luck with everything – there is a lot of good information and support out there!

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Fiona

Great article! Would love to be able to have a “print” icon as I’d like to read offline and share with my husband. Is this possible?

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Jasmin Beck

Please could I also have a print icon as I hope to be getting a printer this week and would really like to have hard copies to show the staff here,
I have e/mailed a few to the Social Worker and she is so impressed, she wants a meeting with Manager, staff and me as they aren’t trained in this area and my complexity of issues makes it so hard on staff to know what to do wrt mental illness.
Thank you for such a helpful and knowledgeable site

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Cindi shore

i have always been aware of the deep breathing techniques. I will try and use them on my 8yr old daughter. I had terrible anxiety as a child but I was labeled depressed and given Prozac which in the end was the worst thing for me. As an adult I need medication to control it. I hope I can use the techniques to help her. Thank you!

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heysigmund

You’re welcome. I hope your daughter is able to find relief some relief with this. Understanding what the deep breathing is actually doing to your body makes a difference. You will have insights from your own experiences that will be really valuable for your daughter. I’m pleased the article found its way into your hands. Thank you for making contact with me.

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Jennifer Whorley

Thank you so much for this. I have been anxious for years and take Lorazepam to settle it. My 10 yr old son is now suddenly anxious and I was dreading what was to come for him. He and I are going to tey these techniques together. Perhaps I can kick my adivan and perhaps he will never need to turn to it. Thanks again.

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heysigmund

You’re welcome! I so pleased you’ve found the articles. It’s a great idea for you to do them together. Would love to hear how you go (as I would with everyone!) Thank you for getting in touch.

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Leah Layden

I am so glad I read this article. This is exactly what I have had an issue with since I have been very young. I have been doing most of what you suggest. Thank you for the useful tips and information. They are extremely helpful to me.

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Kathleen M

Thank you for this article. My daughter(38) has been suffering with anxiety issues since July. She feels the anxiety is under control, but still cannot sleep and has been complaining of severe headaches for several months. She has been to many doctors, therapists, chiropractors, psychiatrist, and counselors. X-rays, MRIs and CT scan show no physical problem. The counselor seems to believe it’s self caused, and that she needs to use the coping skills they’ve given her, which you’ve mentioned above. I don’t know what to do to help her.

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heysigmund

The main thing is that a more serious physical cause has been ruled out. That’s really important. Her counsellor would be basing the assessment on all of the information to hand. Here is the link to an article that explains anxiety in a more adult form http://www.heysigmund.com/dealing-with-anxiety/ , though to be honest, the kids version has made more sense of what’s happening for people. I really get that – the simplest explanation is often the best. Pass the information in the article on to her and most importantly, keep being there for her. Don’t underestimate the importance of that. She’s lucky to have you.

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Peter

I went through anxiety at 35, completely out of the blue, suddenly I couldn’t talk at presentations or even meetings. I couldn’t even hold a drink without shaking at a meeting. I became a master of missing meetings and stopped volunteering for the presentations.
Looking back I believe the onset was related to some back spasm medication, but once anxiety gets a hold of you I don’t think it matters what started it. I knew the fear was not rational, but I couldn’t stop it. Even after throwing away the medication it took me more than a year to overcome my anxiety completely. This all took place before there was so much readily available information on the internet and I also foolishly didn’t ask anyone for help.
I naturally found the breathing techniques helped, but what really dug me out of the hole was the gradual realization that I actually wanted to speak in front of people. Just like I enjoyed the thrill of a horror movie or competitive sports, surfing or even skinny dipping. It was normal to feel some fear, and so I effectively trained my brain (amygdala I guess) to recognize the butterflies as the first stages of the buzz that I would get from my performance at the meeting. Perhaps I’m just making sure the dopamine levels start ramping up in time to quell the amygdala chain reaction. It didn’t happen overnight and I won’t pretend it was easy at all, but it did work for me.

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heysigmund

Wow you are walking proof of some fascinating research done at Harvard where they found that relabelling ‘anxiety’ as ‘excitement’ actually helps performance. The idea is that when you’re ‘anxious’, you’re focussing on potential threats but if you relabel it as ‘excitement’, you’re focussing on the opportunities. So the strategy you’ve been using (possibly since before it was ever studied by Harvard), has been scientifically proven to work. You’ve gotta love that! Here’s the link to the article and the research if you’re interested … http://www.heysigmund.com/an-unexpected-way-to-deal-with-performance-anxiety/ You never know who might benefit from this information. Thank you for taking the time to share your story.

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Michelle

Hi Peter
Your story fascinates me as I went through almost the exact same experience. I was in a top job and brimming with confidence until I was prescribed very strong pain killer medication to quell back pain as a result of a slipped disc. I ended up becoming reliant on the medication for 2-3 years and gradually lost confidence, became depressed, anxious and paranoid. Soon after stopping them (doctor made me) – I had a total meltdown and had time in hospital. It was a scary time for me…but more so for my husband and close family seeing a once cheerful, outgoing and confident woman turn into a confused, scared and anxious introvert. That was over 6 years ago and I am please to say that incorporating almost all of the techniques in this article helped me (and my family!!). Great article and interesting story Peter.

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Peter

Michelle,

My little reminder motto “Love the edge, respect the edge”.

In the interest of sharing, the medication I was talking was Feldene Flash (Piroxicam). Although the result was pain relieve, it’s really a non-steroidal anti-inflammatory drug. The literature did not mention anxiety as a side effect, and I cannot be certain it was the cause, but I notice that wikipedia now lists “nervousness” as a possible side effect.

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James

Hey,

Loved your article, and the one about Anxiety in kids, very well written and great advice. I am a person who has fought the battle of anxiety for a little over 10 years. 10 years of my life has been eaten into by what I call my dark passenger. I thought it was interesting in the kids article about calling it a hero, to me its a villain. My anxiety is mostly health anxiety and I feel symptoms all the time. The chest pain you explain in this article is a constant daily occurrence for me, not to mention being light headed and dizzy. Plenty of tests have been done on me to rule out stuff but I still battle with the answer as to why I always feel this way. Many articles I read on anxiety says that people will experience these symptoms when they have anxiety attacks or during high anxiety moments. What about all the time? Even as I type this I have chest pain and light headedness. The way I feel is enough to send a person to the ER daily to get looked at, yet I’m still here and feel this way constantly. Any thoughts?

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heysigmund

I’m so pleased you enjoyed the article. It’s interesting how different things can work for different people, isn’t it. I’m sorry to hear about the severity of your chest pain. It’s really important that you’ve done all of the tests and ruled out anything other than anxiety. Chest pain can certainly be explained in the context of the fight or flight response and the neurochemicals that get released, but it’s important that anything else is ruled out. It must be distressing to have it happen so regularly. Getting your breathing under control is the most important thing – it will release neurochemicals that will reverse the fight/fight response. Counselling would help you to deal with your anxiety long term. I had a scout around and found this: http://healthworkscollective.com/frmeital/34420/how-stop-anxiety-induced-chest-pain-30-seconds – I can’t say whether it would work or not but it sounds like its just a way to really focus in on your breathing so it might be worth a try if you haven’t already. Would love to know how you go.

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Ann Kerley

My 20yo son is an electrical apprentice and works punishing hours 10-12 hrs per day, in a very physical environment; he is totally exhausted mainly because he feels the need to prove himself and man up to the demands made of him. He stresses greatly at whether he is measuring up and is in a constant state of high anxiety. He skates in free time so is exercising and doing something he loves. He has supportive family but recently moved out of home to live independently with his brother. Comes home and keeps in touch with us. He says he feels like he is going to have a nervous breakdown – is angry all the time and not coping.
Any advice would be appreciated. PS did not really warm to the psychiatrist he was referred to by our GP so reluctant to return. Not on meds. Has lost ++ weight.
Many thanks for your articles
Ann Kerley

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heysigmund

It sounds like your son is really going through it at the moment. You sound like a wonderful support for him. It sounds as though he’s doing a lot and expecting a lot of himself. It’s so important that he has you it important that he’s exercising – that’s a different type of physical . There’s so much research literature on the importance of that for mental health. If his anxiety is reaching breaking point, it might be worth talking to a counsellor. Counsellors come from a different background to psychiatrists so will approach the issue differently. It sounds as though your son didn’t have a great experience with the psychiatrist, and that happens sometimes, but it’s important not to write off all mental health professionals. They come with different training and different backgrounds to each other. Even two counsellors can have vastly different ways of working with clients. It’s about finding the right fit. I would certainly recommend it. I hope that helps. My very best wishes to your son.

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andrea

would love to read about coping with health anxiety when you also have “real” health problems eg I have ME and so cant use exercise to help. Struggling with work and dont know which illness is “feeding” which – is the anxiety making the ME worse or the other way round. Now struggling to work physically ( childminder) thank you

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andrea

just to say I also have diverticulitis disease, small hernia, and inflamed esophagus to add to the equation, help look after my mother who has suffered depression all her life and I take 10mg cipralex which clearly is not working well. when I get “new pains” etc my anxiety is out of control. help.

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Aimee

This is one of the most practical and genuinely helpful articles I’ve read on anxiety. Thank you! Looking forward to reading more on your blog 🙂

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allison

hi im a 17 year old girl and i have been struggling with anxiety since i was in the 4th grade (im a senior now) and its worse then ever im going to try these things i hope they help because i cant go in to school at all this is my last year so its supposed to be fun righ? wrong i started back to school on august 8th and its now the 24th ive only been there one full day and thats because my mom sat there and waited the whole 5 hours (i go to a small privet school this years graduating class has 4 kids in it) im there from 830 to 130 i really want to stay by myself but im terrified and my school is in a church the rooms we use are rooms little kids use on sundays and im a christian so i should not be scared i should feel safe because you need to get buzzed in or have a key to get in the building so i really shouldnt be afraid and i say what if waaay to much i worry about having a panic attack i say to my mom every morning and evening what if i have a panic attack my mom then says well what if you dont and its a battle getting out of bed but im gonna try these i have a membership at title boxing so i think im gonna go back there and exercise and all that.

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