Advanced and Applied Deep Breathing Taking
August 2, 2010 6:56 AM   Subscribe

What are some quick techniques to mitigate my own (mainly physical) stress response?

I am nurse practitioner student in a competitive, well-regarded program at a big state school known for its medical/allied health/nursing programs and gigantic teaching hospital. The program and its associated clinical rotations are intense and difficult, but I am doing well. In general, I handle highly stressful situations well--I am able to be very methodical in critical patient care scenarios, simulations, big exams, and I prepare. This is a second career for and I'm a mom, so I have the advantages of work/life experience.

But. A class I am taking this summer has become a bit of a boogeyman. It's a well-known to be a ridiculously hard course across all the medical/allied health/nursing colleges, but I adore and perform well with the general foundational principles of it, and a meeting with the professor has found no fault in my study/preparation for it, so I think I have worked myself up into a kind of irrational, physical stress response when it comes to this class.

The course has weekly quizzes that are truly more like mini-exams (and a final). After the first couple, which were face-melting, I became apprehensive about the next one. Until, now, halfway through, I am experiencing heart-pounding/palpitations, cold sweats, shaking, head buzzing whenever I merely open up my materials to study. This intensifies when the quiz is actually in front of me. Rationally, I am prepared, studied, and know the material. However, this physical stress response is not helping, and I am concerned it will bleed into other, inevitable, stressful situations.

What can I do, immediately, as soon as I start to feel all fight or flight, to soothe my sympathetic nervous response? What are some techniques I could use to head off the feeling before I begin looking at the material, so I can start to associate the experience with what I know it to actually be, rationally (vs. a scary beast I must slay)? I am looking mainly for easy, physical exercises--a breathing technique, a meditation idea, yoga pose, whatever. Right now this reaction is discrete to this course, and feels like I could get it under control if I had some consistent practices.

I understand that this could be a symptom of a larger stress issue, and so I appreciate taking it seriously. Certainly, if a few anti-stress exercises don't address it, or it grows, I'll cheerfully find expert assistance. But when I take that weekly quiz today, how can I move, calm, understand my body to arrest my insides clanging around like a bunch of brass bells?

I am female, mid-thirties, generally good health, eat fine, get the RDA of exercise except for a few lazy lapses, perhaps don't sleep as well as I should, coffee and tea--yes, absolutely.
posted by rumposinc to Health & Fitness (7 answers total) 8 users marked this as a favorite
I find that breathing out slowly helps. So, I'll breathe out for a count of 10, breathe in normally, breathe out for a count of 10, etc...
posted by wyzewoman at 8:13 AM on August 2, 2010

Let me start by saying I know that this suggestion is a bit ridiculous, but it helps me when I feel a panic attack coming on.

Did you ever watch Sesame Street? Do you remember the pinball animation with the "1-2-3-4-5-6-7-8-9-10-11-12" song? (you have hear this song to really understand what comes next) Well, I sing that to myself in my head, paying attention to where each inhale and exhale falls within the counts. At first, I'll get 2 or 3 complete inhale/exhale cycles within a single 1 to 12 counting verse. I know that's breathing too fast and shallow, so I'll try to extend each breath to the point that it takes until 10 or 12 to do a full inhale, then hold it for a bit and exhale slowly. I like that song specifically because it's easy to remember and the counts give me structure. It gets bonus points for being sung by The Pointer Sisters (!).

Like I said, it's rather silly and I probably look like a crazy person, but better the kind of crazy that sings to myself than the kind that runs out of the room in a full-on tizzy. Also, by the time I've gotten my breath under control, I've forgotten that I was actually about to panic. You know you're okay when you can really get into and enjoy the ending, with the extended "tweh-eh-eh-eh-eh-eh-elve".
posted by Eumachia L F at 8:15 AM on August 2, 2010 [2 favorites]

HOLY CRAP! I do the same thing that Eumachia does! I find that the combination of breathing and going through the song in my head calms me down too. I'm sure that any song that's less than 10 seconds long would work too...
posted by shrabster at 8:22 AM on August 2, 2010 [1 favorite]

I had to cut my caffeine way back earlier this year. Anything over 2 cups ramps up my anxiety and panic, even at bedtime.

Performers often resort to eating bananas before a performance to relieve anxiety, and if those don't work, they get a 'scrip for beta blockers. I'm taking them for mild hypertension right now and the side effect is that I am less anxious overall.

Another thing that helped me in college: in my Psych 101 class, they asked us to volunteer for grad student studies. I signed up for hypnosis and test anxiety. There were several sessions, and all the hypnosis was done from a tape and it really worked. Without spending tons of money, you could go to a bookstore and look for a hypnosis CD or try one of any number of hypnosis sites & download an MP3 to listen to before you study or at night before you go to bed. If you ask around, there may be someone in the hospital who uses hypnosis, I think they are teaching it more and more to nurses now.

One thing that helps me currently, especially if I am alone, is turning on some mindless cooking show or a History channel documentary (the narrators' voices are very relaxing). That distracts my brain, as does a noise machine that has various settings, including white noise.

If you can get to the part of just opening the book, and time yourself, do 10 minutes of study then 10 minutes of walking, jumping jacks, or even dancing to music, then you can condition yourself to do the next part, and so on. Exercise is good: exercise just before the task will help your body and nervous system more (from my experience).

I'd also try and change the place you study. Your response might be different in a library, where there are other people around. Or get a study partner: if this course is so difficult, there must be someone else who feels the same way and would love to reinforce their knowledge and have a buddy to commiserate with. If you can't do that, find a friend you can call to encourage you. Sometimes the beasties of the mind are overwhelming when you're faced with a task alone. Remind yourself that the course has an end, it won't go on forever, and there are no lions waiting to jump out of the book at you. Test anxiety is really common.
posted by Marie Mon Dieu at 9:09 AM on August 2, 2010

I pretend I am going up in the air, in my head, like a zoom out, and I can see myself stressing down below. I see me at my desk, then I go thru the ceiling, thru the roof, up over my city, etc etc until I realize how "small" my stressful situation is then I come back to it. I like quiet and darkness, hence ShadePlant, so maybe that's why imagining I am floating around in space helps... (YMMV). Ground control to Major Rumposinc. Good luck!
posted by ShadePlant at 9:11 AM on August 2, 2010

Oh! Also! My cognitive psych prof told us that we perform on exams better if we mimic the conditions of how we study. For example, if students in an experiment studied while drunk then they did better on the exam while drunk but not sober. In your situation, chew gum when you study then chew gum during the exam. Or wear the same sweater or whatever you can mimic.
posted by ShadePlant at 9:13 AM on August 2, 2010

I got this simple but highly effective tip from John Selby's Quiet Your Mind, and would highly recommend picking up a copy for learning additional techniques:

When you want to calm down, simply focus on at least two sensory inputs at the same time. Pick anything you want (your breath, the sounds around you, your heartbeat, your chest rising and falling, the tension you hold in specific muscles). Concentrating on at least two areas will make it almost impossible to keep thinking worried thoughts.
posted by susanvance at 10:35 AM on August 2, 2010 [3 favorites]

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