Denise has struggled with mental illness most of her life. She also has family members with mental illness. She speaks from experience.
Anxiety Often Feels Like the End of the World
How is Management Possible?
Just like an old shoe we would like to discard, anxiety can be uncomfortable, unruly, and difficult to manage. The pain, discomfort, inability to rest properly, headaches, muscle fatigue, and stomach upset get old real fast. We wish we could go shopping at the mall for a new body!
If only getting rid of anxiety were as easy as buying a new pair of shoes! More of us would be able to move on with our lives and leave it behind. My experience with General Anxiety Disorder has taught me that it is more like a chronic illness that requires daily management.
As evidenced by the work of Toussaint, Nguyen, Roottger, Dixon, Offenbacher, Kohls, Hirsch, and Sirois1, the tool of progressive muscle relaxation is effective in relieving the tension that is related with anxiety and allows management of the myriad symptoms.
The following paragraphs include my own experience with progressive muscle relaxation, how it works, and links to articles and videos that teach the technique.
Even Old Shoes Can Be Useful
Progressive Muscle Relaxation
Progressive muscle relaxation was first introduced to me in the Mental Health Unit. I had called my general practitioner after picking up a handful of pairing knives while doing dishes and, in my mind's eye, seeing it going into my chest and the blood flowing from my body.
The experience frightened me and made me realize that I was in a very dangerous place mentally. I had previously been healed after surgery ended a ten-year health crisis and didn't know how to live with a healthy body. The suicidal thoughts were only part of the many issues I was dealing with.
My diagnosis of General Anxiety Disorder resulted in numerous sessions of therapy and the use of biofeedback to help me learn how to relax my body. My therapist started me on guided progressive muscle relaxation, and I immediately learned that I could increase my ability to sleep using the technique.
The Mechanics of Progressive Muscle Relaxation
In the Health Library of The University of Michigan Health, the article "Stress Management: Doing Progressive Muscle Relaxation,"2 there is a chart outlining each area of the body and what is required for the muscle to be clenched, and then relaxed. The following summary addresses the various muscle groups and the procedure to follow:
- Extremities: arms, hands, legs, feet - make a fist with the hands, point and curl the toes, and/or flex the muscle tissue in the arms and legs.
- Shoulders, neck, and back - shrug the shoulders up and back, arch the neck backward, curving the back inward toward the chest.
- Face and front of neck - scrunch up the forehead, cheeks, and mouth. Bring the head forward toward the chest.
- Stomach, buttocks, and pelvic area - squeeze the buttocks together, harden the abdominal area on itself, and tilt the top of the pelvis toward the back.
Focus on each area of the body as it is tensed, then feel the tension leave as the muscles are relaxed. Keep breathing deep and count with the second hand of the clock, breathing in while tensing the muscles for 8 seconds, and letting the tension go while breathing out for 10 seconds.
The concentrated combination of deep breathing and muscle tensing and relaxing clears the mind of unwanted anxious thoughts and enables the body to settle into a peaceful rest.
Step by Step Progressive Muscle Relaxation
In her article "Progressive Muscle Relaxation (PMR) for Anxiety," (Progressive Muscle Relaxation (PMR) to Reduce Anxiety (verywellmind.com) Katrina Star, PhD outlines five steps:
- Get Comfortable
- Breathe deeply in the diaphragm
- Tighten and release your muscles from the bottom up
- Continue to work your way up your body
- Take a few more deep breaths
In contrast, Anxiety Canada's article found at How to do Progressive Muscle Relaxation (anxietycanada.com), outlines only three steps:
- Tension – tense the muscles in groups – be gentle, there should not be intense or shooting pain
- Relaxing the tense muscles – after five seconds of tension, relax the muscles while you exhale
- Start with the feet and systematically move up
Personalizing the Process
When I first started doing progressive muscle relaxation, I used a cassette tape with soft music and spoken words to guide me through the process, similar to the videos contained herein. This was effective for a time, but I found that I couldn't use the technique in a public place when I really needed the assistance.
Since then, I have found that visualizing myself tensing the muscles was just as effective as actually tensing them. Now, I start at the top of my head and move down as follows.
I breathe deeply, inhaling for 8 seconds, and exhaling for 10 seconds. As I begin the exhale, I visually focus on one area of my body, beginning at the top of my head and going down gradually, saying "Relax your forehead," "Relax your eyes," "Relax your nose," "Relax your lips..." Each at the beginning of the 10 second exhale.
As my body relaxes, anxiety dissipates, and I am able to rest, if I am lying down or in a sitting position, my mind ceases the racing thoughts that are leading to physical symptoms. Daily progressive muscle relaxation helps manage anxiety symptoms allows more enjoyment in life.
1. Toussaint, L., Nguyen, Q. A., Roettger, C., Dixon, K., Offenbächer, M., Kohls, N., Hirsch, J., & Sirois, F. (2021). Effectiveness of Progressive Muscle Relaxation, Deep Breathing, and Guided Imagery in Promoting Psychological and Physiological States of Relaxation. Evidence-based complementary and alternative medicine : eCAM, 2021, 5924040.
2. Author: Healthwise Staff. Medical Review: Patrice Burgess MD - Family Medicine & Kathleen Romito MD - Family Medicine & Adam Husney MD - Family Medicine & Christine R. Maldonado PhD - Behavioral Health. Stress Management: Doing Progressive Muscle Relaxation | Michigan Medicine (uofmhealth.org).
This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
© 2022 Denise W Anderson