Understanding anxiety

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Anxiety - Mark Ettensohn, Psy.D. Sacramento Therapist

Chances are good that you know someone who is dealing with some form of chronic anxiety. In fact, according to the National Institute of Mental Health (NIMH), there’s an 18% chance that you are dealing with it yourself.

What is anxiety?

Anxiety is a clinical term that describes a set of cognitive, emotional, and physical symptoms. For most, the physical symptoms of anxiety are uncomfortable and distressing. Common symptoms include rapid heart rate, sweating (or cold sweating), dizziness or faintness, shakiness, stomach upset, and shortness of breath or hyperventilation. Some people even experience pain.

These physical symptoms result from activation of the body’s sympathetic nervous system (also known as the “fight or flight” system). When we perceive danger, our bodies go into a hard-wired mode that prepares us to either fight for our lives or run away. Digestion is interrupted to conserve energy and blood flow to vital systems (hence the stomach upset). Our bodies are flooded with adrenaline to help with quick muscle movements (hence the shakiness, sweating, dizziness, and rapid heart rate). Our breathing becomes quick to help oxygenate our blood (hence the rapid breathing and hyperventilation).

Basically, the physical symptoms of anxiety are really just the body going into emergency mode. If you were really in danger, these “symptoms” would be life-saving physical changes that gave you increased strength, endurance, and reaction speed. It is only when they occur in the absence of actual danger that we treat them as a disorder.

When we talk about anxiety we are really talking about fear. We are all familiar with fear. We all know what it’s like to be startled – the sharp, quick gasp; the way our hearts pound shortly afterward. These symptoms of being startled don’t in themselves cause us alarm, because our brains understand what caused them. Once we determine that there’s no real danger, the physical signs of fear go away. Sometimes, we even have a good laugh about it.

But people treat anxiety differently. They begin to miss work, or stay home from school. They stop socializing with friends and family. Over time, people can restrict their behavior so dramatically in response to anxiety that they never leave the house. What started out as a small issue can quickly spiral into a very big problem that significantly interferes with a person’s life.

Unlike the experience we call “fear”, which tends to occur in response to an obvious situation that we can identify, the physical symptoms of anxiety can seem to come out of nowhere. When our hearts pound during a scary movie, we can easily identify the cause. We are therefore not afraid of the physical symptom itself. But with anxiety, we are often unable to identify the cause. Our minds try to help us out by identifying the symptoms themselves as the threat. Thus, a person who has a sudden panic attack will interpret the unexplained symptoms as a heart attack or think that they are going insane. This only increases the fear, and the symptoms become worse as the person spirals out of control. It can be a truly terrifying experience.

“Nothing is to be feared but fear itself.”

When it comes to anxiety, FDR’s famous words come to mind. The basic treatment for every anxiety disorder involves helping the person to recognize their symptoms as the body’s normal fear reaction. The symptoms themselves are uncomfortable, but harmless. The only way to get rid of anxiety is to ride it out. In fact, the most effective treatment for panic attacks is to help the person have a panic attack and then ride it out until it stops. They have to see for themselves that it really is harmless.

If you suffer from anxiety, try this:

When the anxiety flares up, focus on your breathing. Take slow, deep breaths in through your nose and all the way into your belly. Focus your attention on your breathing and tell yourself that the symptoms you are having are harmless and just your body’s way of trying to protect you. Your mind thinks you are in danger, but it’s just mistaken. Focus on your breathing and let the anxiety swell to its peak and then gradually go away. If you ride the anxiety out like this a few times, you will likely notice that it begins to happen less often and less intensely. A trained therapist can help you learn to recognize the thoughts and situations that trigger anxiety symptoms, and can help you gradually learn to cope with the symptoms in more effective, healthy ways.

…let me assert my firm belief that the only thing we have to fear is…fear itself…”

― Franklin D. Roosevelt

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