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Living with Anxiety

WHAT YOU MAY NOT KNOW ABOUT ANXIETY

Angry WomanThere are some things about anxiety that few people realize. For example most people don’t know that anxiety:

  • …is something that can be helpful.
  • …is a warning system for danger that is built into your mind and body.
  • …is not dangerous on its own.

Most of the time we talk about anxiety like it is purely a bad thing, when in fact it exists to help us. It’s an evolutionary process that helps keep us safe in certain circumstances. It’s when this anxiety seeps into other parts of your life that it can become problematic. There are many ways it can drastically change your view of yourself, the world, and how you live your life, which ultimately can cause harm.

Anxiety is a set of thoughts (or cognitions) paired with physical reactions. These will crop up when you experience something stressful in your life. Anxiety, as an emotion, exists to help you recognize danger and prepares you for dealing with it to keep you safe.

That reaction, called the fight or flight response was designed to keep us out of harm’s way. (Yes, freeze should be in there too. Many people do respond to some crisis with inaction.) There are many possible situations where the fight or flight response can keep you safe. You want this instinct to take control if you are being attacked, if a car is speeding towards you, or other situations where you are in immediate and apparent life-or-death danger.

When this important instinct kicks in, our brain and body are pairing up to do exactly what is needed to help you survive and be safe. In other words, if your life's on the line, you want the fight or flight response to take control. That function of your mind and body is your protector, and it does not mess around.

But what happens when our brain and body start viewing everyday stressors as “crisis”?

WHEN ANXIETY BECOMES PROBLEMATIC

Anxiety becomes a problem in people's lives when:

  • ...it is significantly interfering with how they live their lives
  • ...when the physical and emotional reactions of the fight or flight response becomes chronic
  • ...when the reaction occurs regularly when not in the face of a crisis
  • ...when the reaction becomes more intense and affects their everyday life

Imagine for a moment, this is what is going on in your brain:

You are worried about succeeding at work, you want your kids to get good grades, you question if you are fitting into social situations, you worry about the continued health and well-being of loved ones, being safe in a crowded place, successfully landing when you are a passenger in an airplane, encountering unexpected noises/sights/sensations, and infinite other situations.

It’s enough to distract anyone. Now imagine that your brain and body unintentionally react to those situations or even thoughts about those situations with a mode that was only designed to be activated in life-or-death circumstances. Sounds disastrous, right?

You can easily become fixated on the problem or the unexpected physical responses associated with your stress trigger. If every time you experience stress, you have an overly exaggerated physical response, this is clearly anxiety provoking.

Keep in mind that how abrupt those physical symptoms can be if you don’t know why they are happening. If your heart starts to pound, you start to sweat or you feel light headed for seemingly no reason… it can be scary!

This is when instinct kicks in to do whatever it takes to make it all stop as quickly as possible in order to feel safe again.

Your body needs the fight or flight response to survive. But you don’t need every problem, issue or worry in your life to lead to this instinctive response reserved for a crisis. And you certainly don’t need to like it when it happens. For many people dealing with problems resulting from their anxiety, this is a huge understatement.

THE PHYSICAL REACTIONS OF ANXIETY

The physical reactions that accompany the fight or flight response:

  • ...are intended for immediate survival, so there is no subtlety to them
  • ...are not experienced by everyone
  • ...some people don’t even recognize them as being a sign of panic

There are a host of possible physical symptoms that stem from the response. Some of the most commonly reported include:

  • Increased heart rate (in addition to feeling faster, it could feel like the heart is pounding)
  • Pressured breathing (could feel like shortness of breath, choking, muscle pain in the chest)
  • Shaking legs or hands
  • Stomach distress (needing to go to the bathroom or nausea)
  • Sweating
  • Chills or hot flushes
  • Numbness or pins-and-needles sensations
  • Lightheadedness or dizziness

Believe it or not, these are all designed to help you survive a dangerous situation where your safety is in jeopardy. The problem is, they’re not all that helpful when you experience stress preparing for a presentation at work, getting ready for your college prep test, going on a first date, attending a party or professional networking event, entering a setting in which you will be interviewed for your dream job, or other situations where you are out of your comfort zone, but not in mortal danger.

ANXIETY AND UNCONTROLLED THOUGHTS

In addition to the physical reaction to the fight or flight response, you will also have a flurry of thoughts in those moments of stress or crisis. These thoughts:

  • ...are also intended for immediate survival, but our highly developed brain capacity has a few other tools at its disposal
  • ...could be beneficial, but usually ends up going the other way when someone is anxious

In these moments of heightened arousal, chances are your brain cycles through all the things that could happen (“What if ...?” times a million). You will think through the worst-case scenarios, and all the disastrous consequences of what could happen. When in an emotional state, your brain wants you to be prepared for anything and everything, and will make sure you are paying full attention.

What happens when this occurs at less than ideal times. Think, late at night as you are trying to go to sleep. Sound familiar?

In survival-mode, if you are not aware and fully prepared, you could be as good as dead. When your brain is in fight or flight mode, it will do whatever it takes to prevent the worst from happening, even if it means you can’t sleep, don’t leave the house, are constantly on high-alert, can’t be by yourself, and so on.

You can start to see why a system that is designed to keep us safe can actually become detrimental to our health when it spins out of control.

MY APPROACH TO TREATING ANXIETY

My approach to treating the effects of anxiety:

  • ...starts with emphasizing that the fight or flight reaction isn’t the problem
  • ...it is based upon changing your reaction to the reaction
  • ...ensures that anxiety no longer has control over how you live your life

In order to accomplish this, we work on developing important skills that address your particular physical sensations and associated thoughts. We also work towards changing your behaviors in the moment so that you can achieve what you want in stressful situations. By decreasing the intensity of the anxiety or panic you experience, we will lessen the likelihood of the reaction happening in the future.

AN IMPORTANT NOTE ABOUT ANXIETY TREATMENT

What we won’t do:

  • ...focus on how to eliminate anxiety from your life
  • ...spend time trying to eliminate stress that you don’t have control over

You need this important warning system for situations where it is unbelievably beneficial and the only thing that stands between you and life-or-death danger. Anxiety and stress are a fundamental part of being human. But this doesn’t mean they have to control our lives.

At the start of treatment, you will learn that coping skills are like a buffet-style restaurant. By sampling different meal options you will figure out what you really like. Chances are you will even go back for more. Coping skills are something that you may need to try and figure out what fits you best. Those are the skills you will use again and again. Anxiety psychologists understand that coping skills are not one size fits all!

When working with you I will use two tactics. First I will teach you the techniques that have been proven effective. Second I will point you in the direction of specific apps or audio tracks that do a great job of teaching particular skills. Our goal will be to find at least one go-to skill for the physical reactions (diaphragmatic breathing, progressive muscle relaxation, calming imagery, etc.) and one for dealing with the flurry of thoughts (cognitive reappraisal, mindfulness, acceptance, etc.).

We will work together and you can decide for yourself which ones are effective and which you are most comfortable using when needed. Once you pick your favorites, we’ll sharpen your ability to use them how and when you want. We will continue to make adjustments as you become more proficient with these skills and tweak them for particular situations as needed.

COMMON QUESTIONS ABOUT ANXIETY

While the basic ideas still apply, the approach requires some tailoring. Because abstract thinking skills and the ability to see the “big picture” are still being developed in younger children, the explanation and delivery method are adjusted to accommodate their developmental level. They are usually able to understand that a part of their brain is trying to protect them, but doing it at the wrong time.

I compare this response to a broken fire alarm at their school or a really over enthusiastic puppy that barks at everything. They will start to see that the system is a good one, but only when it’s working properly.

Over time they will find a calmer place by using their preferred coping skills. While we won’t delve too much into the fight or flight reaction, I will explain that there are things they can do to help themselves feel better in situations where they don’t need or want to feel anxious.

Whether you take medication or not, the techniques I use have been shown to help people deal with the anxiety they experience in a healthier way.

Some people have the goal of discontinuing medication entirely. We can work towards that goal. Others are more comfortable staying on medication (or have it available) to help with the process of not letting anxiety dictate their lives. Also a goal we can work towards. Still others want to see how well the strategies and skills can help them before making up their mind. That’s fine, too.

You have control over what works best for you. My job is to teach you everything you need to know to be able to make the best decisions for you.

This is a promise that the vast majority of anxiety therapists won’t make. Our brains will react to more situations (real or imagined) than we can ever dream up. This makes it very hard to say that you will never have any anxiety based reaction. I can help you find the skills that work for you and assist you in developing ways to practice them between sessions. I can guide you in establishing a mindset where you know you could feel anxiety, but have the skills available if it threatens to pull you away from achieving your goals in life.

Your brain can always perceive danger where there isn’t, but with some time and practice - you will be ready.

A FINAL WORD ON ANXIETY

While anxiety can stand in the way of living your life fully, this doesn’t have to be the case. There are steps you can take to improve your life.

If you or someone in your life is struggling with the unwanted impact of anxiety, you have options. It may seem like the solution is out of reach, but for every problem, there is a solution. Let us help you find yours.

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