When we discuss long term recovery from Panic symptoms and Depression it is very important that I cover the topic of setbacks. Let's look at what a setback is, why it happens and how to view a setback when it happens to you in your own journey. 

A big part of achieving long term recovery from Anxiety and Panic is to understand that you will have set backs along the way. Recovery from these symptoms is not automatic anxious to not anxious, it just does not happen like that. It is a windy road of good and bad days whilst learning how to handle your symptoms all the way.

If you are recovering from Anxiety you will have setbacks during your road to being well again. Period.

When you have your first episode of Panic or Anxiety and by that I mean the very first time you feel it, that is square one.

After that it is impossible to return to square one as however big your forward or backward steps are, you have always increased your knowledge, understanding and resilience to your symptoms.

It's not realistic to assume that once you have learned to control your symptoms that your life will have no Anxiety in it at all, or no days of low mood.

Before you had Anxiety/Panic or Depression you will have had days of low mood, the only difference being is that you just accepted them, you acknowledged them but paid them little attention. Anxiety is a part of normal life and everyone will experience anxious moments at some point such as before a job interview, or before an operation. Anxiety at this level is normal and not a problem, its only when it is so strong and persistent that it affects the ability to function that it becomes a problem. This Is the Anxiety that we would like to remove, the type that comes when we are not in danger, the unhelpful panic feelings we experience after thoughts or during situations that pose us no threat and are not dangerous.

Going forwards a big part of understanding levels of recovery is to understand and accept that on route to the end goal we will experience some setbacks.

I was once told Anxiety recovery (and Depression for that matter) is "one step forward and two back" and I feel this is very true. I found during my own recovery that it can be very up and down. It's not black and white, you don't go literally from ill to better. Its often a windy road that has many twists and turns and takes time.

Understanding setbacks can prevent you falling back into the Cycle and feeling helpless once again. Knowledge is power and the object here is to understand and accept the process and remove much of the fear of not knowing what is happening to you.

So what is a setback?

A setback is generally a feeling that your symptoms have returned. You feel like there is no point and you are right back at square one.

Initially, when you find the courage to begin to face your fears and move towards recovery, you gain confidence and feel better. Then without warning weeks later you feel a return of symptoms for no apparent reason. Because you feel that you were moving forwards and doing everything you could to get well, you had begun to feel the progress and could feel the hope as your confidence began to return. You they could see your quality of life returning.

The return of symptoms happens, just when you had found the courage to slowly face your fears. You were finally convinced that you were moving forwards but ultimately you have feared these symptoms for so long so it comes as a massive shock when you feel the symptoms again despite all your efforts to recover.

Suddenly, the symptoms feel too strong to overcome and efforts to continue seem pointless. This thing feels like it's too strong, it has an unbreakable hold over you and you can never escape. The tendency is to give up allow the symptoms to flood over you once more and lose your hope, thinking you are right back at square one and are one of the unlucky ones that will never recover from this. The more you think like this, the stronger the return feelings become and the worse you feel. Now your will to carry on and your hope seem to be passing you by. You are experiencing a setback.

Setbacks happened during my own journey to recovery and I fell into four serious setbacks as well as many slightly less serious ones before I learned what was happening and learned to view and deal with my setbacks in a different way. Then I was able to continue moving forwards whether I experienced a set back or not.

At the time I didn't understand that set backs were an important part of the recovery process or viewed them as such. I took each one that happened to me as my cue to spiral again and really thought I was back to square one. 

Successfully learning to handle Panic, Anxiety or Depression involves changing your perceptions on how things look to you and how they actually are. If we relate that to setbacks, it is about looking at them as an important part of recovery, a sign that you are moving in the right direction and that they are actually increasing your capacity to deal with your panic, work with it and gain confidence in yourself to handle it. That is a good thing.

It is about seeing and viewing setbacks as the same bad day that you had before you suffered with anxiety and paid no attention to. That is the secret.

It's about understanding that you and you alone are responsible for how much of an impact each setback has on you or how long it lasts. They anxiety is not in control of that, you are.

Recovery from Panic is full of twists and turns and is not just straight forward. It's just not that black and white.

You will suffer setbacks, but you do have a choice how bad the setback needs to get or how you choose to deal with it.

So what is the secret to handling a setback?

Firstly, it is about understanding what set backs are and understanding that they will happen, some will last hours, some will last days but it will go away. The only time any setback would last longer is the way you are looking and perceiving it, for example if you were to throw in the towel every time you have a bad day then of course your setback would last longer, that is logical.

You are not back at square one, that is scientifically impossible, as this is all a process and you are learning all the time.

Slow down, be aware that the setback is there and work through it.  In my own journey through Anxiety, I learned to slow down and work through any bad days I had while grabbing enjoying my good days. 

Once I stopped seeing my setbacks as a return of symptoms that would overpower me and never go away, I never saw them in a negative way again nor did it occur to me that I wouldn't just get back up and continue on to my end goal. I weathered my bad days, accepted that they were there even if I didn't like them and looked forward to enjoying my next good days and continuing onto my goal. In this way I found my setbacks had a much shorter duration and became more and more infrequent while my better days became gradually more frequent.

It is important to carry on as normal, even if you are uncomfortable. Acknowledge that your set back is there but allow the panic to do its thing and rage around you if that is what it wants. You just keep living and paying it little attention..

Let me give you an example of a client's setback that I worked with who had been suffering a fear of being stuck on a dual carriageway so he had been avoiding driving down dual carriageways all together.

Once he had found the initial courage to face his fears his recovery looked a little like this.

Day 1 - He was feeling very frightened but manage to drive a short way down a dual carriageway.

Day 2,3,4,5- He had similar feelings but managed to continue to drive down the dual carriageway even going a little further each day.

Day 7,8,9 - He was now completing his drive everyday and gaining in confidence going further and further.

Day 10,11,12,13- He is feeling fantastic. He feels he has overcome his fear and it's no problem to him anymore. He has even managed to sit in stationary traffic on the dual carriageway and handled his fear.

Day 14- He completed the same journey and suffered anxious feelings that resulted in a panic attack. He is now feeling very deflated and like he is back at square one. He cannot understand why his negative feelings returned when he was making such huge steps to overcome them. He loses hope and feels that despite his efforts that this is much stronger than him, there is no point, he can't do it and he will never recover.

He has lots of negative feelings, increasing anxiety, and feelings of hopelessness. The set back is in control.

This reaction can put my client back easily, however a lot of the way he has fallen back into things is just about not having enough knowledge about the process and what is happened and also the way he is looking at the effects a setback can have on him.

At this point he can give up, allow the feelings to wash over him once more and think that everything has come back or he can add to his knowledge on setbacks, and see the process in a whole different way, which will in turn help him to overcome his setback , gain more confidence in himself to deal with things and continue to move forwards to his goal of removing all the unhelpful panic from his life.

So what should he have done?

In short day 15 should have seen him get right back up and back on the dual carriage way, noting to himself that this is a normal panic process and rather than it blocking his path to recovery, it is in fact proving that he is on the right track and making progress by:

  • Improving his confidence and belief in his own ability to handle things
  • Learning that a setback does not mean it's all over, by proving that nothing has changed as a result of it. His progress is still there.

In this way despite how bad he was feeling on day 14, by the end of day 15 or 16 his set back would have been diminishing. This is why it is so important to understand that a setback is nothing more than a test to see if you can handle it and no matter how bad you feel if you continue on it will pass over and you will become stronger and much more able to deal with your symptoms.

I certainly began to have a degree of acceptance of setbacks and taught myself to rise to the challenge each time one decided to bother me. Learn not to pay it any respect or real attention as it does not deserve it. In fact I almost welcomed them eventually.

I learnt to slow right down and work through my bad days, while grabbing my good days and returning back to person I was on these days. This plan worked well for me.

I figured my mood also had to jump about a bit before it found its correct regular level again, so I also let that do its thing whilst I carried on doing mine.

Normal living means normal life will return.

However bad your setback feels, start to refuse to let it drag you back down where you do not want to go. Maintain your level of recovery without  the setback forcing you to take another step backwards, because when you emerge from each setback, you will be amazed how much stronger you will feel as a result of it.

Allow it to do its thing and wait for it to pass over. It will pass over.

At worst you will understand through falling into a setback that you won't do it again.

Over time you will learn that Panic, Anxiety and Depression are great teachers as a whole and when giving you setbacks they are teaching you courage, strength and resilience.

This is a journey and a process , understand that and always keep the end result in mind.