Ways to manage anxiety for adults with learning disabilities and autism

• Anxiety can make you think and feel different things.
• This can stop you doing things you would normally do.

If you are feeling anxious, you might:

• Have a fast heartbeat
• Breathe faster
• Feel butterflies in your tummy or feel sick
• Have trouble sleeping
• Feel moody
• Feel sad

Lots of things can make you feel anxious. Sometimes, you may not know why you are feeling anxious.

Breathing Exercises

Ways of changing your breathing to help you feel calm.

Grounding with your senses

Using sight, touch, noise, smell and taste to focus on things around you.

Guided Visualisation

To help you imagine that you are somewhere else.

Progressive Muscle Relaxation

An activity that reduces stress in your body tensing and relaxing your muscles.

When you are anxious your heart beats faster and you breathe faster. This can make you feel even more anxious. Changing the way you breathe can help you to calm down.

Practise these breathing exercises with your support worker when you are calm.

Belly Breathing (lying down)

1. Lie down on your back.
2. Put 1 hand on your belly and your other hand on your chest.
3. Breathe in deeply so that your belly fills up with air. The hand on your belly will go up and the hand on your chest will stay still.
4. Breathe out slowly. The hand on your belly will go down and the hand on your chest will stay still.
5. Repeat until you start to feel calmer.

Belly Breathing (sitting)

1. Sit comfortably on a chair.
2. Put 1 hand on your belly and your other hand on your chest.
3. Breathe in deeply so that your belly fills up with air. The hand on your belly will go up and the hand on your chest will stay still.
4. Breathe out slowly. The hand on your belly will go down and the hand on your chest will stay still.
5. Repeat until you start to feel calmer.

Pursed Lip Breathing

This method can be used during times when you are feeling anxious or panicking.

It is a powerful way to control hyperventilation, slow a rapid heartbeat and promote physical comfort.

For this reason, it is known as the Calming Breath.

Here's how it goes:

1. Breathe in slowly through your nose.
2. Hold your breath while you count 1 – 2 – 3.
3. Breathe out slowly through your mouth as though you are gently blowing a candle out.
4. Repeat until you start to feel calmer.

Square Breathing

Square Breathing, is a technique used when taking slow, deep breaths. It can be a powerful stress reliever.

Before you get started, make sure that you’re seated upright in a comfortable chair with your feet flat on the floor.

Keeping your hands relaxed in your lap with your palms facing up, focus on your posture. You should be sitting up straight. This will help you take deep breaths.

1. Sit with your back straight and your feet flat on the floor.
2. Breathe in slowly while you count 1 – 2 – 3 – 4.
3. Hold your breath while you count 1 – 2 – 3 – 4.
4. Breathe out slowly while you count 1 – 2 – 3 – 4.
5. Hold your breath while you count 1 – 2 – 3 – 4.
6. Repeat until you start to feel calmer.

This helps you focus on the now and feel calmer. You can use your senses to help you focus on things around you.

When you have finished, say something positive about yourself. For example:

• I am a kind person
• I make people happy
• I have a loving family
• I have a great smile

Grounding with your senses

Take some slow, deep breaths. Say out loud or write down:

• 5 things you can see
• 4 things you can feel
• 3 things you can hear
• 2 things you can smell
  
• 1 thing you can taste

This helps you to imagine that you are somewhere else. It can be used to help you feel relaxed and calm.

You can play music that helps you feel calm or happy in the background.

You will need someone to read the scripts for you. They should be read slowly and in a soft, calming voice.

Please feel free to change the scripts to suit the person who you are helping to relax. Use the photos to help the person imagine the place.

Before you begin, make sure you are in a comfortable position. Breathe nice and slowly, focusing on each breath.

Guided Visulisation Script (at the beach)

Picture yourself at the beach.

The rays of the sun are soft and warm.

You can hear the sound of the seagulls and the waves gently splashing on the sand.

The waves roll in and out, in and out. Each wave makes your feel more relaxed.

You can see the clear blue sky and the sparkling water.

You can feel the sand in your toes and a gentle breeze blowing on your skin.

You slowly breathe in the sea air and with each breath, you feel more relaxed.

You feel safe and calm.

Picture yourself at the park.

The rays of the sun are soft and warm.

You can hear the sound of children playing in the distance and the birds singing in the trees. Each bird song makes you feel more relaxed.

You can see the blue sky and the fluffy clouds.

You can smell the freshly cut grass and feel it tickling your toes.

You can feel a gentle breeze blowing on your skin.

You slowly breathe in and out and with each breath, you feel more relaxed.

You feel safe and calm.

Picture yourself in (your safe place)

You feel warm and calm.

You can hear (sounds that make you feel safe e.g. Dad’s voice, music)

You can see (things that make you feel safe e.g. pictures, pets, family)

You can smell (smells that make you feel safe e.g. washing powder, Mum’s perfume)

You can feel (things that make you feel safe e.g. favourite blanket, soft toy)

You slowly breathe in and out and with each breath, you feel more relaxed.

You feel safe and calm.

Please note 'At the park' and 'At your safe place' scripts are available on the Easy Read Guide to Managing Anxiety.

This is an activity that reduces stress and anxiety in your body by having you slowly tense and then relax each muscle. This activity can make you feel relaxed straight away, but it is best to practice often. If you have any pain or injuries, you can skip that area of your body.

You will need someone to read out the instructions for you. They should be read slowly and in a soft, calming voice.

Lets begin!

1. Sit back or lie down in a comfortable position. Shut your eyes if you are comfortable doing so.
   Take a deep breath and feel your lungs up with air.
2. Hold your breath for a few seconds and then breathe out slowly.
3. Take in another deep breath and hold it. Slowly breathe out.
4. Now move your attention to your feet. Begin to tense your feet by curling your toes and the arch of your foot. Hold it and let go. Repeat.
5. Next, begin to focus on your lower legs. Tense the muscles in your calves. Hold it and let go. Remember to continue taking slow, deep breaths. Repeat.
6. Next, tense the muscles in your upper legs and pelvis. You can do this by squeezing your thighs together. Hold it and let go. Repeat.
7. Begin to tense your stomach and chest. You can do this by sucking your stomach in. Hold it and let go. Allow your body to go floppy. Repeat.
8. Breathe in slowly and hold it. Breathe out slowly. Repeat.
9. Tense the muscles in your back by shrugging your shoulders. Hold them as tightly as you can without straining. Hold it and let go. Notice how different your body feels when you let it relax. Repeat.
10. Tense your arms all the way from your hands to your shoulders. Make a fist and squeeze all the way up your arm. Hold it and let go. Repeat.
11. Tense your face by screwing it up or making a silly face. Hold it and let go. Repeat.
12. Finally, tense your whole body – your feet, legs, stomach, chest, shoulders, arms, hands and face. Tense as hard as you can without straining and hold it.
13. Now relax and let your whole body go floppy. Focus on the feeling of relaxation and how different is feels to being tense. Enjoy the feeling of relaxation.
14. When you are ready, begin to wake your body up by wiggling your fingers and your toes. Slowly move your arms and legs and have a big stretch.
15. When you are ready, open your eyes and sit or stand up. Give yourself some time to enjoy the feeling of relaxation before you start doing another activity.

In the guide, you might notice that some of the activities are shorter than you would expect. This is done for a reason – we want them to be accessible for people who may not be able to concentrate for a long period of time or follow a large number of instructions.

Some of the activities will require support from another person, and they can be adapted to suit the person using them.

For the other activities, someone with a mild Learning Disability should be able to follow and complete them independently.

I hope you find the guide useful.

Acknowledgement

Breathing exercises adapted from The Best Breathing Skills for the Fear of Flying.

Development of these activities were informed by Relaxation for People with Disabilities.