Relaxation-Related Exposure: Anxiety and Light-headedness
Patients can be helped to better tolerate or accept other physical symptoms of anxiety such as the sensation of becoming light-headed or dizzy. Like the rapid heart rate and breathing, it is important that your primary care doctor or specialist rule out physiological causes for this symptom and attribute them strictly to anxiety. For example, sometimes, outright dizziness symptoms is directly caused by a momentary physiological changes e.g., blood pressure, as in orthostatic hypotension. Some patients with anxiety will any report feeling vaguely “light-headed” or “mentally ‘out-of-it’”, “something like dizziness” or that they are experiencing a disconnection with the immediate passage of time.
With regard to exposure, we may coach them to duplicate some of the symptoms of becoming light headed by standing up and turning around in a few circles, taking extreme care of course, that they do not get truly dizzy and fall. Stand right next to a couch or soft chair so you can sit or lie down quickly and assess whether they have simulated the light-headed or dizzy condition they experience when having an anxiety event. They are then coached to simply go through the breathing and heart rate exercise and note the moment when the light-headedness or dizziness begins to subside on its own. Some patients can do a good job of literally imagining becoming light-headed when they are not actually having this symptom, immediately after taking rapid walk, coming home and are in the midst of completing the self-monitoring procedure (outlined in the section on simulating fight or flight symptoms).
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