What I Have Learnt from Working with People who Suffer from Severe Anxiety, by Zenta Zaldate.
During my years as a fitness professional, I have met so many people who have struggled with their mental health. Some cases are more severe, some less so. Some would come to me willing, wanting to improve their life quality or fitness level and eventually open up about their challenges. Some would find me specifically to learn how to use exercise as a mental health management tool. I also find more and more people get in touch with me after being recommended exercise by their GP.
When I was studying to become a Personal Trainer, mental health was something we quickly brushed over. Sure, you can take extra courses and specialise, but I’m struggling to understand why we didn’t focus on it during the syllabus. Personal Trainers often create open and honest relationships with their clients. Not only do we incorporate physical exercise and diet in clients’ lifestyle, but we also help our clients reshape their schedule, attitude, habits and mindset. This includes tackling the mental health challenges that might affect a person's ability to take on a healthier and more active lifestyle.
Interestingly, once they get past those first challenges, people I have worked with admit that the exercise and routine it provides have helped them to deal with their anxiety better.
Normalising mental health
I find that more and more people are talking about mental health as much as they would talk about painful backs and knees. When I mention that in the past I’ve seen a cognitive therapist, many clients and people around me have admitted that they’ve seen one too, were thinking about seeing one or have certain issues they would like to address. Understanding that you are not alone in this can help you build the courage and stop ignoring something that is clearly affecting your life. So let’s have a conversation about our mental health!
Every person experiences anxiety differently
Assuming that you understand how someone's mind works is a fast track to failure. It takes observation skills and a different approach for every single person to deal with someone else's anxiety. Behaviours vary from being unable to concentrate on exercise, to full-on panic attacks or fainting. Helping someone who has anxiety caused by a traumatic event can be just as challenging as helping someone who developed it from constant stress at work.
However, as my time with a client is limited and I'm not a mental health therapist, I've had to come up with tools that would be helpful in a wide range of situations and help us (myself included) to work together. If you have anxiety, or you care for someone who does, you might find these tips, tricks and observations useful. Disclaimer: I am not a certified mental health therapist. These are just thoughts and my personal experiences.
Anxiety often causes people to try and avoid or escape from unpleasant situations they are in. This behaviour can manifest itself as chatting a lot, the sudden need to go to a toilet or drink water, and other actions in the middle of the task given. In my case - an exercise set.
I usually allow a client to indulge in their distraction for 10 seconds and then remind them about exercise or start matter-of-factly counting my reps again. If you stop the attempt of distraction too early, they can feel attacked, get even more anxious or grumpy. Letting it go on for a bit and reminding them about activity makes them realize their behavioural pattern and try to control it better.
If you are a constant chatter try using time-based training with a stopwatch instead of counting reps, it will help you focus instead of stopping in the middle of exercise.
Professional friendship can make someone go that extra mile for you
Another problem is avoidance, constant cancellations, and being late to organised sessions. A person who really wants to train and change their lifestyle might find it harder to stick to their set goals as they are struggling to juggle life and mental challenges thrown at them.
I have gone that extra mile for a few of my clients who have shown me that they do want to take the training seriously, but are struggling to stick to it because of their mental state. I even go as far as showing up at their doorstep and kicking them out of bed. Yup - I have done it actually countless times. But it is not the norm and you and your trainer/therapist will have to come up with strategies that might help you work together.
I find that communication is the key in working with someone who suffers from anxiety. And it’s the only way to build a strong enough relationship for someone to not want to stop working with you.
A client once sent me an article ‘How can I help someone with anxiety?’ It’s a guide for family members and loved ones, of which I’m neither. Still, I can offer you a support system and help you come up with a strategy that makes this trainer/client relationship successful.
It was a nice gesture to open up a conversation. And I did find it very helpful. Trying not to be judgmental, showing support, avoiding phrases like ‘Calm down’ are useful tips. However, what this article did the most was allowed us to be more honest and set up a language that worked. Try not to lie about what you have or have not done, how you feel, what you have eaten, and why you didn't show up. It will allow us to tackle certain anxiety triggers and let the client be more consistent with training, eating and managing other everyday activities.
Sound and social anxiety
Being in the gym for the very first time is a stressful experience for many. Especially for people who struggle with a social anxiety disorder. Feeling like you are being watched or judged, feelings of inadequacy, not being comfortable with your body can lead to a high stress response and trigger anxiety attack.
Looking around a lot, sweating, nervousness, not listening are signs of high discomfort and racing thoughts. In those situations, I usually place clients away from others, perform exercises facing the wall, key them to look straight forward and concentrate on their physical being. I might use calm, direct voice to draw their attention to exercise or loud sounds and claps to startle someone and shake them up, making them snap out of their thought process. Everyone reacts differently to it.
Gyms have loads of amazing, useful equipment but you might find it easier starting your fitness journey in a park or class setting where you can get a base understanding of movement and feel less judged. Move to a gym when you feel comfortable with a few simple exercises and go from there.
Your body is amazing
I touch people a lot. My hands are my tool to understand what is going on under clients skin. There are cases when people might be uncomfortable with it. I found that after a while it helps clients to look at their body as an amazing mechanical machine it is. When feeling anxious a touch on a shoulder just like sound can sometimes ground you. I believe that that's how a hug from a person close to you works when you are upset.
A client once told me that me touching their leg and explaining how muscles are doing their job made them realise that I don’t find it’s wobbliness disgusting and that it’s just a tool to do things.
Noticing how muscles contract, how physical you are helps with drawing attention to the benefits of exercise rather than looks. It helps many people to start to appreciate their body more and not be so obsessed with skin, fat rolls, looking sexy or not sexy enough while doing lunges.
Take a look in a mirror and bend your arms. Notice how your biceps are moving under the skin. Think about all the daily activities this simple contraction helps you perform. It is simply amazing.
Dealing with panic attacks
Physical pain, dizziness, increased heart rate or exhaustion is a common companion of exercising but, unfortunately, it can trigger panic attacks. Breathing is the main tool to combat it. Try to calm down, concentrate on your breath. If it is something that happens often you might choose to participate in activities where the main focus is on your breath, like yoga. You also might want to train with a friend who will talk to you while you calm down.
If you are interested in weight training but are uncomfortable with pain that’s caused by muscle contractions or dizziness that sometimes comes after very heavy sets, try to start gently and learn to retranslate this feeling. Pain is a burning sensation - it is not dangerous or the same as injury. Dizziness can be caused by blood not providing enough oxygen to your brain, so sit down and breath!
Anxiety disorder is recognised more and more by health professionals 1 in 25 people might be affected by general anxiety disorder. What it tells me is that we need to be more aware of it and share our experiences. I would love to hear your tips and tricks about exercising and implementing a healthy lifestyle if you live with an anxiety disorder. So, leave comments or send us an email: firstname.lastname@example.org