Recently I've started going to therapy sessions (obviously and sadly now cancelled due to COVID-19) and been working through my issues and worries. A lot of this is down to my anxiety which I've suffered with for a long time, as long as I can remember really. When I first started secondary school, I suffered very badly with my anxiety and panic attacks, to the point I would have to hide in the toilets during registration period and have a panic attack in there and calm myself down to be able to go to my lessons of the day. I kept it a secret for a long time and didn't understand what was going on until I started seeing counsellors and getting referred to the children's mental health team, but now I'm very aware of my anxieties and triggers and try to use this to help others.

So my new therapist picked up on my struggles with my anxiety and decided to use a social anxiety help sheet with me to help me deal with my bpd and anxiety episodes. What I do is after I have what I call an 'episode' (crying, paranoia, panicking, sadness etc) is I use the sheet to talk through with myself - and later my therapist - what happened to try and narrow down what triggered it and what I could do in the future to help the situation. I'm finding it helpful and using the prompts now when I'm having an episode to try and calm myself down again.

Situation And Trigger
What happened? Who? What? Where? When?
What did I notice?
What did I react to?
So firstly, let's write down what happened that started the incident. What was going on? What stimuli did you react to?
e.g walking to the shop alone and began feeling anxious. Noticed my breathing getting rapid and palms beginning to sweat

Feelings, Emotions and Physical Sensations
What emotions did I feel? How intense were they?
What did I feel in my body?
What were you feeling at the time? Were you sad, angry, frustrated, upset? Was it mild or was it intense emotions? What other feelings did you get, sweating, crying, panic?
e.g felt incredibly nervous, sweating, heart racing, struggling to breathe, felt sick

Unhelpful Thoughts or Images
What went through my mind?
What's the worst that could happen?
What did I think others would notice?
What were you thinking at the time? What unhelpful thoughts were you thinking?
e.g anxious that people would be in the shop and would look or laugh at me, people could be talking about me or I could have a panic attack in public, others will notice I'm breathing funny and think I'm weird

Self-Focus
Where was my focus of attention?
What did I notice about myself?
What were you thinking about at the time? Was it about yourself, how you looked, how you were acting etc? Could you notice anything about yourself, like any symptoms?
e.g focusing on what could happen if I go into the shop and have a panic attack, noticed my hands tingling and palms sweating

Safety Behaviours
What did I do that helped me?
What did I do to try and stop it happening?
Did I have an urge to do anything?
So what did you do to calm yourself down, did you ring someone, do a breathing exercise, sit down for five? Did you try and catch it before a panic attack happened? Did you want to do something, like run away, go back home etc?
e.g rang a friend to do some breathing over the phone with me and help me calm down, had the urge to run away but decided to fight it

Rational thoughts and Self Focus
STOP! Take a breath, is this fact or fiction?
Is my reaction proportionate?
What's really happening? 
What would someone else say?
Is what's happening or what you think is going to happen true or have you imagined it up in your head? Do you know that you'll have a panic attack or are you thinking you will? Are you reacting proportionately? Is going to the shop a scary activity worth panicking about?
e.g imagined I would have a panic attack, I'm just walking to the shop which is easy and not a scary activity, someone else would think this was silly

Outcome - What did I do, how Did it Help?
What could I have done differently? 
What helped me?
Did what you do to help yourself work? Should you have tried something else as well or instead? What helped you in your situation?
e.g Could have stopped earlier to avoid a panic attack, but ringing a friend helped me calm down and not have a bad panic attack in the end.


So that's my anxiety activity worksheet, maybe have a go next time you have an incident where you're struggling and see if you can identify some triggers and see what will help you next time.

Let me know how you get on!
Meg x