Is Anxiety Holding You Captive?
You receive a memo from your supervisor that you’re to update a group of managers on a project, and you have only a few days to prepare. The thought of standing before the group makes your head spin, your heart beat out a staccato rhythm and your palms sweat. You want to a dive under your desk.
Do you find yourself frequently reacting to stressors this way? If it happens often enough, these feelings might indicate a disorder. The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders defines generalized anxiety disorder as “the presence of excessive anxiety and worry about a variety of topics, events or activities. Worry occurs more often than not for at least six months, and is clearly excessive.”
If you relate to this definition, you’re far from alone. According to the Anxiety and Depression Association of America, “Anxiety disorders are the most common psychiatric illnesses affecting children and adults. An estimated 40 million American adults suffer from anxiety disorders. Only about one-third of those suffering from an anxiety disorder receive treatment, even though the disorders are highly treatable.”
There are a few reasons someone might avoid seeking treatment. These include:
- Denial that the condition exists
- Acclimation to the emotions that accompany it
- A habit of self-medicating with substances or behaviors
Anxiety-provoking circumstances might include speaking in public, taking a test, driving to an appointment or meeting new people. Situations need not be extreme to bring about an2310z anxious response. Anxiety is a learned pattern for some people.
The Mechanism Behind the Panic
Clients commonly wonder in therapy whether the thoughts precede the physical sensations of anxiety or the body’s reaction to an event sparks stress-inducing thoughts. The mechanism that leads to overwhelming anxiety is akin to the fight, flight or freeze response that floods the brain with the stress hormone cortisol.
The amygdala and hippocampus also partner in the vicious cycle of anxiety. The amygdala’s role is to moderate between the components of the brain that process sensory input and translate the messages. It sounds the alarm when one’s faced with a threat — real or perceived. The hippocampus then stores and encodes the input into memory, so that the next time an emotional or physical challenge arises, the body has a frame of reference for how to respond. Compounding the problem is that the amygdala often can’t discern between genuine and imagined danger. It can’t tell the difference between when someone’s being assaulted and when they’re recalling a previous attack.
The impact of living with high levels of stress that provokes hyper-arousal can last a long time, and the reaction to stimuli can be immediate. Consider the example of a woman who survived the Blitzkrieg in London in WWII when she was 5 years old. Although she’s now in her 80s, hearing a siren or a car backfire or seeing a Nazi flag can send her into paroxysms of panic. She’s cognitively aware that the traumatic events aren’t occurring in the present, but her automatic, unconscious response reacts as if they were.
When Anxiety and Excitement Team Up
“Feeling anxious is very unpleasant, so people go to great lengths to avoid it,” social scientist Alison Wood Brooks, an assistant professor of business administration at Harvard Business School, told Harvard Magazine in 2014. For example, when someone’s uncomfortable during a negotiation, “they exit early, they make large concessions, they respond very quickly to counteroffers, and ultimately they perform poorly,” she said.
Learning to differentiate between anxiety and its close cousin, excitement, can help, Brooks said. She explained that the two “are very similar emotional states. Both emotions are high-arousal, signaled by a racing heart, sweaty palms, and high levels of the stress hormone cortisol.” Her studies have found that people perform better when they assign those sensations a positive meaning, thinking of them as excitement rather than as stress or anxiety.
Alternatives for Addressing Anxiety
It’s hard to prevent the sensations associated with anxiety, but you can put your body’s response to stimuli into context. Here are a few suggestions for moderating feelings of anxiety:
- Rate it before you can negate it. Evaluate your anxiety levels on a 1-to-10 scale. Notice whether they change depending on circumstances. Be aware of what sets the anxiety wheels in motion, so you can be better prepared to stop their turning.
- Do a head-to-toe body scan. Notice the sensations you’re experiencing, and perhaps even say out loud, “I’m noticing my heart beating more rapidly. I’m aware that my mouth is dry.”
- If a memory triggers anxiety, reassure yourself with the words, “I’m here and now, not there and then.” Look around and find an object that wasn’t present when the original event occurred.
- Take deep breaths. Your automatic reaction is hold your breath in an anxiety-provoking situation.
- Ask yourself, “What’s the worst thing I can imagine happening in this scenario?” Answers might include appearing foolish or injuring yourself or someone else.
- Know the difference between yellow-flag caution and red-flag danger. Is this event something to be wary of or to avoid altogether?
- Consider cognitive behavioral therapy, which addresses the core thoughts known as cognitive distortions that reinforce anxiety. Examples of these distortions include polarized or black-or-white thinking, jumping to conclusions, and catastrophizing.
- Also consider exposure therapy, which gradually introduces the anxiety-inducing trigger in a safe and controlled manner so the trigger can lose its impact.
- Get in physical exercise, which can reduce anxiety by releasing the feel-good chemicals of neurotransmitters, endorphins and endocannabinoids.
- Incorporate relaxation techniques such as meditation, yoga, tai chi or chi gung.
- Breathe deeply. Inhale to the count to four, hold to the count of four, then release to the count of four. Imagine as you do this mindfulness practice that the anxiety is leaving your body on the exhale.
- Create a pronoiac journal. This practice involves writing about the positive people and experiences that enter your life daily. The word “pronoia,” popularized by writer John Perry Barlow, is the idea that the universe is conspiring to help you — or the opposite of paranoia.
- Engage your humor muscles. Laughter is the best medicine — one that requires no prescription and is highly addicting.
By Edie Weinstein, LSW
Follow Edie on Twitter at @EdieWeinstein1