Understanding and Treating Anxiety

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Understanding Anxiety

During my first year in graduate school, I worked with a professor who made the study of anxiety his life’s work. He would appear at research meetings, perspiration marks streaked down to his waist, his hands clammy and his forehead drenched with sweat. He seemed restless, shuffling his papers and shifting in his chair. “I’m highly anxious,” he declared as an ice breaker on that first day. “I’ve always been like that.” I learned a great deal about fear and anxiety from this professor. One of the lessons that he taught was that a little bit of alertness or tension can help a person’s production and performance, but too much can paralyze.

Fear and Anxiety: Arousal Gone Haywire

What is the difference between fear and anxiety? When we are afraid, there is a perception of a pressing threat or danger such as encountering a mountain lion on a hiking trail. This is followed by a quick arousal response from our limbic brain and the desire to escape or to defend.

Those of us who are anxious have developed a world construction in which everyday activities become scary or overwhelming. If you’re highly anxious, you’re generally a worrier. Work, school or relationship concerns can seem filled with potential dangers or catastrophes.

We call it an anxious state when there is a judgment of threat that is non-specific, such as the danger of embarrassment if we mess up during a public speech. In cases of severe trauma such as in childhood sexual abuse or physical violence, the alert system becomes ever vigilant and techniques may be needed that can reset the person’s arousal mechanisms. EMDR, Brain Spotting or other Trauma Resolution therapies might be useful to reset your system.

Signs and Symptoms

One of the common features of an anxious response includes avoidance of the feared or scary situation. For example, if I’m terrified of public speaking, I might stay away from jobs or work assignments where I have to present. Avoidance often reduces the state of arousal, and therefore offers temporary relief. However, avoidance can interfere with our daily lives, making work a nightmare or preventing us from activities that we enjoy, for example, as when fear of flying stops us from visiting grandkids. Some of us might avoid social gatherings or public bathrooms. Others might steer clear of any situation from which where it could be difficult or embarrassing to make an escape such as in a crowded airport.

Some who experience anxiety suffer from panic attacks. A sudden rush of intense fear and terror (arousal) associated with a sense of doom can be accompanied by shortness of breath, heart palpitations, chest pain and physical discomfort. Fears about going crazy, losing control or having a heart attack send people to the emergency room.

Worries and Obsessions

For many who are constantly anxious, worrying can become a repetitious soundtrack of possible dangers. My cousins affectionately called my uncle a “worry wart,” because he couldn’t stop raising potential concerns about everyday things. These worries seemed exaggerated, but he appeared unable to stop. For him, it might have been an attempt to solve or issues that were beyond his scope. For others, this worry style might have more to do with chronic procrastination and the use of anxiety as a motivator to spur action. One of my patients ruminated in order to keep her children safe when they went skiing with her ex-husband. She recognized that for her, worry helped her feel like she was doing all she could to protect them.

Assess Your Anxiety Style

If you would like to undertake a quick anxiety self-assessment, try the Anxiety Inventory located in the Forms Section. The purpose of the scale is to provide you with information about this important mental health topic. If you have any questions about this scale or want more information, you are encouraged to contact me.

Treatment Approaches

As our knowledge about anxiety issues has increased, many methods of treating it have been developed. Cognitive behavioral therapy (CBT), in which a person’s habitual conditioned negative beliefs and automatic thoughts are recognized, recorded and systematically challenged, can be coupled with relaxation techniques such as deep breathing and visualization. (picturing safe alternatives). With phobias such as fear of flying, public speaking and agoraphobia, and in cases of trauma-related fear and anxiety, (Post Traumatic Stress), EMDR (Eye-Movement Desensitization and Reprocessing), Brain Spotting and visualization techniques can be very effective tools.

Frustrating patterns that contribute to chronic worry as a motivator can be addressed and replaced with more satisfying and productive approaches. And of course, in some situations such as with panic disorder, OCD (in which obsessive thoughts and compulsive behaviors or rituals interfere with a person’s life), etc. targeted medications can be combined with many of the above techniques to achieve effective results.

Four Anti-Anxiety Strategies

If you’ve decided that you worry too much and wish to try some self-help measures, please consider some of the following suggestions.

  • Consistent deep breathing can generate a relaxation response and lower blood pressure and a state of arousal in many. Please see Dr. Kate’s Blog, Twelve Good Breaths on this website.
  • Schedule a worry and review time. If worries interfere with your sleep, try writing them down before you go to bed and commit to a consistent worry time the next day. Choose a time to review these issues that is at least six hours before bedtime so that it does not interfere with sleep. If you can, choose the same time every day. When you do your review, go over each item you’ve written down. Place the items that you can solve along with the intended solution on one side. On the other, record the issues that you can’t readily solve or that are beyond your control.
  • Focus on what works and what you do well rather than on what isn’t useful.
  • Your Personal Serenity Mantra. Identify the issues that are beyond your control, or where you’ve done everything in your power to influence the situation. Is it time to let it go? Depending upon your personal belief system, develop a few words that you can use to reassure yourself.

Basic Anxiety Screening Test