Fear of Falling Understand It, Beat It Understand It, Beat It Fear of Falling About This Information Booklet

Fear of falling Understand it, beat it Understand it, beat it Fear of falling About this information booklet

Many of us will, A fear of falling can also at some time, have lead to us dropping out of activities we like to do and “The best way to never a fear of falling. staying at home more. This can result in a loss fall is to never get up For example, experiencing of confidence and feelings slipping on ice on a winter’s of boredom, frustration from your chair” day can leave us feeling and loneliness. shaky. As a result we may walk cautiously for a while This information booklet is afterwards, and it may take for anyone who has a fear ...but it wouldn’t some time to return to our of falling, his or her relatives normal self. and friends.

be much of a life! This is quite normal and understandable – it makes sense to be careful. But a more ongoing, lasting fear of falling can cause problems, by stopping us enjoying life to the full.

Living with a fear of falling can create a lot of worry to family members, friends and ourselves resulting in a lot of distress. 3 Understand it, beat it Fear of falling

The booklet looks at: The emotional effects of having a fear of falling

• The emotional effects of We may feel out of control having a fear of falling of our body and our situation generally. Therefore we may • What does it feel like to be anxious? feel that there is nothing that • How can anxiety affect how we can do. you walk? We feel lonely and isolated from family and friends. • How can you help yourself? Sometimes it can be difficult to talk about how we feel with those close to us. We may not want to worry or upset them.

What does it feel like to be anxious?

For some a fear of falling can There are three parts to the be overwhelming. For feeling of anxiety: example, it can make us very anxious and it can stop us 1) Physical Body from doing the things we sensations include: need to do in our daily lives. • Shaky Legs • Irregular Breathing • Churning Stomach • Sweating • Trembling • Racing Heart 5 Fear of falling Understand it, beat it Understand it, beat it Fear of falling

All of these symptoms are 3) Avoidance Behaviour A vicious circle can result: very unpleasant. However, • We may take some specific We get confidence by Loss of confidence means they are not physically action to make ourselves doing things. ANXIETY and can bring harmful or damaging in feel safer e.g. If we fear we about feelings of failure any way – it’s our body’s will fall we may sit down; AVOIDANCE means stopping instinctive way of reacting if we feel we may collapse, doing things and leads to Avoidance can spread to when we think we are in we may hold on to LOSS OF CONFIDENCE MORE and MORE situations danger. something and so on. These are known as safety 2) Mental Anxiety behaviours. Worry • Constant worrying • We may avoid similar “I don’t feel thoughts, often about the situations in the future. safe walking” fear of falling. • We may only walk with • Fearing the worst – “I will others, which in turn will not be able to get up if I fall”. only maintain our fear of • When we are anxious we falling – as we never get the Lost Physical tend to focus on negative chance to learn what we confidence symptoms things rather than positive can do. “I couldn’t do it, Shaky legs things. For example, “I can I nearly fell” feel my legs are wobbly; I can’t be safe walking” rather than “I’m walking, I’ve not fallen, I’m getting there!” More worry Avoidance “My legs aren’t These thoughts can make Sit down working right, the anxiety worse and may I will fall” even trigger it!

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How can something like anxiety How can you help yourself? affect how I walk? A Step-by-Step Guide

Fear of falling as a risk If we avoid activity we get There might be lots of very However, the physical and factor for future falls unfit and out of shape, which good reasons why you have mental effects of anxiety can also make walking harder worried about falling. can add to the problem, Fear of falling can have an adding to our anxious so by tackling the anxiety immediate effect – making thoughts that walking is Your doctor, nurse, or you may well find that walking us shaky and distracted, difficult. therapist can help and becomes easier and you but it can also have a longer- advise you. rediscover your confidence. term effect. Everyday tasks become more daunting – so we get more We are distracted from anxious and more distracted Dealing with walking by negative thoughts: by anxiety. Physical Anxiety “If I fall, I will not get up, I will When we are anxious we be alone, no-one will be able often over-breathe – taking to help me,” therefore a few slow, deep breaths can reducing our attention and calm you down. ability to complete the task in hand. Practice the relaxation exercise at the end of this The physical effects of anxiety booklet everyday, so that if such as increased muscle you do get panicky, you have tension may make it harder the skills to control it. Anxiety to walk easily and naturally. can also make you tense and relaxation can help with this.

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Dealing with Mental Anxiety 1. Getting ready 2. Walking When we are anxious we tend to notice the bad things Don’t rush! Get up “What do I need to do first, and ignore or dismiss the when you feel ready what do I need to do next?” good things. “Don’t think about other Try to think of positive, Remember to think about things, that’s not relevant, encouraging things, to help your breathing and try to I’m doing alright as I am.” you feel more rather than relax. less confident. “One step at a time!” “I can only do one step at a time, I’ll concentrate on one “Never mind what others Dealing with Avoidance step, then move on to the might be thinking, it’s not Try not to avoid walking. next step.” relevant.” If a long walk seems too daunting, set yourself a “What is it I have to do If you feel tense, shaky smaller goal – one you right now?” or panicky, stop and take aren’t too afraid to try. a few slow, deep breaths. “I can do this, I have in Tell yourself that the Even walking a few steps the past.” unpleasant feelings are only across the room is a good anxiety, and will pass in time. start to getting your “I’ll probably look back confidence back. afterwards, and think what Don’t rush! Go at your was I worrying about.” pace. If you’re with someone, explain that you’ll walk better at your own pace.

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Positive thinking 3. After 4. Next step – preparing Make sure you remind for next time yourself of your Now you have proof of what achievements: you can do. Deal with mental anxiety by reminding yourself Fewer “I did it!” of this: SUCCESS! physical symptoms “It wasn’t that bad after all, “It’s just negative thoughts. I made it.” That’s the problem. When I control them I can control the “I felt uncomfortable, fear of falling!” but I coped.” “Next time, it won’t be Don’t avoid Even if it wasn’t perfect, as bad.” you still did it. Build on your successes! Congratulate yourself – give Once you are fairly yourself a treat, anything! confident, extend your goals – try going a little further. “I can stop the fear of falling happening again. It’s not easy, but I can do it, by working on it, I can break the cycle of anxiety”.

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‘The best way to never fall is to never get up from your chair’ .... but it wouldn’t be much of a life!

We can’t promise that you • Think of all the times that will never fall again but you haven’t fallen. getting the right help from professionals, and using this • Think about how you booklet to help yourself successfully regained your overcome your fears, should confidence before – you’ve make you more confident. done it before, so you can do it again. If you do have another fall, try to put it down to • Try not to avoid walking. experience: • Use the following relaxation • Were you rushing? techniques to cope with any physical anxiety • Did you have the right walking aid?

• Was it something beyond your control, like a slippery floor?

• Try to think positively, rather than let yourself slip back into a vicious circle of worry and avoidance.

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Relaxation techniques

When we are anxious, the • The most effective way of However, the ability to relax muscles in our bodies tense. controlling bodily tension is is not always something When muscles become too by relaxing. which comes naturally. tense, we experience It is a skill, which has to uncomfortable sensations • By relaxing we don’t mean be learned. such as: sitting in front of the TV or having a hobby (although The following exercises are Headache these recreations are designed to help you to learn Stiff neck important too), we mean to relax. When you are able Painful shoulders developing a skill to reduce to relax using the first Tight chest and difficulty unnecessary physical exercise, you can begin to in breathing tension. shorten the routine. Trembling Racing heart • This then helps to relieve This should be done gradually Churning stomach anxiety and the unpleasant until you are able to relax at Tingling in hands and face bodily sensations. When will. Back pain, and so on our bodies are free of tension, our minds tend • In turn, these sensations to be relaxed. can make us even more anxious and tense.

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General guidelines

Relaxation • In advance, try to decide Breathing when you are going to • Try to breathe through your practice; it is helpful to nose, using your stomach develop a routine, which muscles. you can stick to. • Try to breathe slowly and Simple relaxation routine • Make sure that you choose regularly. It is important that somewhere quiet to you do not take a lot of For this short routine you will need to imagine a practice, and make sure quick deep breaths as this ‘Happy Image’. This can be: that no one will disturb you can make you feel dizzy or during your practice. faint or even make your • Repeating in your mind a • Thinking of an image tension worse. sound or word which you which you find calming or • Don’t attempt your exercise find relaxing e.g. the sound soothing e.g. a quiet if you are hungry or have • If you place your hands on of the sea or the word country scene, a flower, etc. just eaten; or if the room is your stomach you will feel ‘Calm’ too hot or too chilly. the movement if you are breathing properly. Feel • Gazing on a fixed object in • Start the exercise by lying your stomach flatten as the room e.g. a picture or down in a comfortable you breathe out; hold it for ornament, which you position; later you can also a moment, then feel it fill particularly like. practice in other positions, out and expand as you such as in a comfortable breathe in. chair.

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The procedure Cued relaxation

This simple method involves 4. Distressing thoughts will When you are able to • This way, you will be focusing on your breathing probably come into your achieve a relaxed state practising your relaxation and on the pleasant / happy mind. Do not dwell on using the above exercises, skills several times each image. them, simply return to your you can begin to practice day. Happy Image. applying these skills 1. Sit in a comfortable throughout the day. • There are all sorts of cues position. Close your eyes. 5. Continue for 10-20 which you might use. Work Think about deeply relaxing minutes. When you finish, All you need is something out what catches your eye your muscles, beginning at sit quietly with your eyes which will catch your eye regularly throughout the day your feet and moving up to closed for a few moments regularly to remind you to: and use it as your reminder. your face. Keep your and then with your eyes muscles relaxed. open. Do not stand up Drop your shoulders; relax • With time and regular and begin moving around the muscles in your body; practice, relaxation will 2. Breathe in through your too soon. check your breathing become a way of life. You nose and become aware of pattern; relax. are bound to experience your breathing. Focus on stress, anxiety and tension your own Happy Image • As a cue or reminder, you at some time – this is and breathe out through might use a small coloured normal. However, you your mouth. spot on your watch or should now have a better clock, which you look at awareness of this and the 3. Do not worry about regularly. Every time you skills to bring it under whether you are good at see the spot, you will be control. the exercise. Keep a reminded to relax. passive attitude and allow relaxation to happen at its own pace.

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Quick muscle relaxation Further information

Sitting on a chair, tense up all Different exercises suit We hope that you have found this booklet useful. the muscles in your legs. different people. Try all three Hold for a few seconds, then practise the one that If you feel you would like more help or advice, you could ask noticing the tension. you like best. With practice, your doctor to refer you to a psychologist, who could work the relaxation response will with you to regain your confidence. • Now let go and relax, taking come with little effort and a deep slow breath out at you will be able to respond Other professionals, such as occupational therapists and the same time. to stress by relaxing almost physiotherapists, might also be able to help you improve automatically. your walking. • Notice how your legs feel loose, floppy and relaxed It is necessary to practice Ask your doctor for more information. now. two or three times a day.

• Sit and enjoy the relaxation for a moment.

• Now do the same with your arms. Tense them up, hold for a second, then let them go loose and relaxed, taking a deep slow breath out as you do. “I did it!”

22 Information reproduced with permission from Vicki Parlane, Assistant Psychologist and Dr Jessica Read, Clinical Psychologist Greater Manchester West Mental Health NHS Foundation Trust

If you would like more copies of this leaflet please contact: Camden REACH Tel: 0845 900 0684 / Fax: 020 7530 5251

Published March 2009. Produced by Fresh Lemon.