uestion 46 '
What is visual imagery?

Pictures in our mind are closely related to our emotional response. Visual imagery is the use of self-directed mental images to create a calm and relaxed state. This technique uses conditional pattern of responses that are associated with a particular mental image. The technique of visual imagery helps to condition relaxation through memorization of relaxed times in your life. If you imagine a favourite place you had visited in the past, this would trigger the relaxation response, (e.g. sitting on a quiet beach or fishing near a stream).

The following is an example of visual imagery.

Imagine walking in the garden at the break of dawn. The soft morning light warms the air and brightens up the scene. The clear blue sky and trees are mirrored on the smooth surface of the lake. A gentle breeze rustles the leaves of the trees. The grass is still damp with the morning dew.

Across the lake is a spreading Angsana tree with foliage of colourful hues of green. Further beyond, the elegant palm trees sway gracefully. There is a feeling of relaxation as you gaze at the beautiful scenery.

You stroll along a path near the edge of the lake and in the water you can see fishes swimming around the lotus flowers.

You sit on a bench in the shade of the Angsana tree. The fragrance from the rose bush fills the air. Take a deep breath of fresh air and exhale slowly. Listen to the chirping of the birds in the trees. In the distance, a white swan glides majestically across the lake.

Now close your eyes. Draw in a deep breath and exhale. You can store this lovely scene in your memory, and you can go there anytime you want to because you have created this imagery of tranquillity in your mind. It will convey a sense of relaxation whenever you recall it.

Now, take a deep breath again and at a count of three open your eyes. You will feel very relaxed and calm.

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uestion 47
What are anti-anxiety drugs?

These medications, also known as minor tranquillisers, are used in the treatment of anxiety and insomnia. The commonest drugs belong to the class called the Benzodiazepines.

Benzodiazepines

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uestion 48
Do tranquillisers like Benzodiazepines have side effects?

Side effects of Benzodiazepines include:

1. Drowsiness, confusion, poor memory. This is more severe in the elderly.
2. Muscle weakness, poor coordination of skilled movements such as car driving or handling complex machinery.
3. When the medication is suddenly stopped after prolonged or excessive use, withdrawal symptoms may lead patients to take them again. The withdrawal symptoms are sleeplessness, anxiety, nausea, tremulousness, muscle tension and occasionally, hallucinations (seeing things or hearing voices when there are none).
4. Depression

   These medications should be used only as long as they are absolutely necessary because of problems with dependence and tolerance. In general, the longer-acting benzodiazepines are least likely to produce dependence and the shorter-acting ones the most likely to do so.
   

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uestion 49
Are sleeping pills safe?

Hypnotics or sleeping pills can be taken for a short period of time. Hypnotics should not be continued for an indefinite period. If you are taking other medications for medical problems, inform your doctor, as certain medications can interact with other.

The most common adverse effects of hypnotics are their residual effects. Daytime drowsiness is common. This can result in a slowing of reaction time and becomes a problem when the patient operates machinery or drives vehicles.

Drug interactions are another important point to remember. The most important interaction is between a hypnotic and alcohol. This combination can result in potentiation of drowsiness with serious consequences.

For children, the prescription of hypnotics is generally not justified.

Hypnotics are prescribed with caution for the elderly. This is because the elderly are more likely to have residual effects during the day, which may cause fall or accidents.

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uestion 50
What techniques would you advise to help me sleep without taking sleeping pills?

1. The best way to sleep better is to keep a regular schedule. Go to bed at about the same time every night. Set your alarm clock to wake you about the same time every morning - including weekends. If you have a poor night’s sleep, don’t linger in bed or oversleep the next day.
2. Avoid stimulating activities (like watching thriller movies) just before bedtimes as these increase your level of arousal and make it harder to initiate sleep.
3. A warm drink like milk may help.
4. Nicotine from cigarette stimulates the nervous system and can interfere with sleep.
5. Alcohol may induce sleep, but more often causes interrupted sleep.
6. A firm comfortable bed in a dark, quiet and cool room helps promote sleep.
7. If you go to bed but find that you can’t fall asleep after thirty minutes, don’t stay in bed worrying about sleeplessness. It is better to get out of bed and leave the bedroom.

   Read, sew, or find some other way to relax before going back to bed.

8. Exercise during the later part of the day helps tire you out. However, strenuous exercise in the late evening can increase arousal.
9. Avoid afternoon naps.

   
   

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