Anxiety Disorder from Psychologist's Perspective

[SavCat]

Hi everyone, I'm Dr. Dan Bochner.  I'm a psychologist and author of two books, the latest of which is printed in its entirety on my website, http://www.DrBochner.com.  The following article was written for everyone.  After all, everyone suffers from anxiety sometimes.

Anxiety

By Dr. Dan Bochner

   Feeling uptight or kind of shaky?  Do you have muscle aches, heartburn, or stomach problems?  Do you suddenly lose energy after feeling alright.  Is the stress in your life taking you to the breaking point?  Does it seem like no one does things right, or that you are just too irritable?  Are you worrying a lot?  Are you having trouble sleeping?  Are you feeling restless, or does it seem like you can’t sit still?  Do you feel just plain nervous?  Do your hands or feet get cold and clammy or start to tingle without cause?  Do you get lightheaded and you don’t know why?  Do you find yourself avoiding certain situations, or sometimes find yourself so stressed in certain situations, that you think you might actually die from pain in your chest or from dizziness or from the pounding of your heart?  If you are experiencing some, many, or all of these symptoms, there is a good chance you are dealing with anxiety.

   Although it is very important to be careful about many of these symptoms because they have causes other than anxiety, or because they can be dangerous even when they do involve anxiety, when these symptoms are caused by anxiety, understanding how anxiety works can be quite helpful.  Anxiety actually has a purpose in human beings that is akin to its purpose in animals.  In animals, there is a fight, flight or freeze pattern that occurs whenever there is something threatening in the environment.  While the animal prepares to either fight, flee or freeze to manage a threat, the animal’s body makes certain changes.  The blood flows to major muscle areas and away from the extremities and the gut, thus causing cold or tingly hands and butterflies in the belly.  Adrenaline makes the heart pump and puts energy into the muscles, which become tense, causing headaches or pain in other muscle areas like the neck, shoulders, or back.  Breathing becomes shallow so the animal can avoid detection, or so it can get ready for an anticipated blow. 

   These changes ready the body for danger, but when human beings experience this reaction, most of the time there is no imminent danger in the environment.  Humans tend to be sensitive to the environment, and react to it rapidly, even when the dangers to which we are reacting pose no physical threat.  Rather, we react to emotional threat, even when it is rather subtle.  Getting ready to speak in front of a group can cause extreme anxiety and really there's no physical danger there.  But even much more subtle circumstances can cause significant anxiety.  When there is a chance that someone will be mad at us, or when we think we need to get our work done more quickly, or when we think we need to rush to get somewhere on time, or for many people, when we're merely listening intently to what others are saying...etc., our bodies will react with the fight, flight or freeze syndrome.  We either ready ourselves for aggression, like a mountain lion protecting its cub, or we freeze up with tension like a raccoon stiffly staring back into headlights hoping it will not be seen.

   Luckily, we are not animals.  Equal to the fight, flight or freeze syndrome (also known as the sympathetic nervous system response) is the relaxation response (known as the parasympathetic nervous system response).  While the fight, flight or freeze syndrome tends to begin without our knowledge or control, we can if we wish, initiate its opposite, the relaxation response, on our own.  When we are relaxed, blood flows throughout our entire body distributing oxygen as homogeneously as possible.  The heart slows down and the muscles lengthen and loosen.  Blood flows to the stomach so it can do its job of digesting the food there.  Breathing deepens and we feel at peace.  Sometimes we begin to get sleepy. 

   We can begin the relaxation response simply by forcing ourselves to breathe deeply for a few minutes (please see article, Breathe!).  Most people who try breathing to recover from anxiety stop their breathing after a few breaths and then give up because they still feel tense.  The trick is to keep breathing deeply for several minutes (if you become lightheaded you need to be less dramatic in your deep breathing, or make sure your breaths are truly deep), while trying to experience a sensation of floating as you inhale and sinking as you exhale.  I have not yet met a person for whom this process, when taken seriously, does not work. 

   Several other relaxation techniques include 1. scanning your body for tension through every muscle group and then loosening your muscles (eventually learning to pay more attention to your body and loosen the muscles as soon as they become tense); 2. imagining yourself in a pleasant, relaxing place, while noticing everything you experience there through all five senses; and 3. rocking yourself with eyes closed while finding your natural rhythm.  The relaxation response of the whole body occurs automatically when you do these things and, because the relaxation response is diametrically opposed to the fight, flight or freeze response, the tension in your body cannot continue while you are relaxed.  In fact, because the body and mind are part of one big system, making the body relax also helps the mind relax, and one's thoughts will typically calm as relaxation continues.

   Knowing how to handle the anxiety one already has is helpful, but knowing how to prevent anxiety could be even better.  The prevention of anxiety requires that its causes be understood.   There are really two main causes.   There is some overlap between these two causes, but in their essence they are very different. 

The first of these causes is that some people have truly experienced many threats in their environment and now interpret the world as a threatening place.  When a person has experienced abuse, unfair treatment, or trauma, they use their way of experiencing to help keep them safe in the future.  Thus, they interpret many different circumstances as threatening and will become anxious in many different circumstances as well.  When you think about it, if a person’s past experiences were extremely traumatic, it would be foolish for them to respond differently.  It seems they have learned that the world is a dangerous place and that they must be ready for more danger.  However, most of the time that natural response is incorrect.  Traumatic experiences of the past are not truly predictive of ongoing experience, except that behaving as though danger is always lurking has a tendency to cause more traumatic experience as a traumatized person tends to place themselves in the familiar, but dangerous, surroundings to which they have become accustomed.  Thus, because a traumatized person predicts danger, their anxiety is exaggerated.  Yet, simultaneously, such a person is truly more likely to experience trauma later, not because their surrounding must be dangerous, but because often only dangerous surroundings and circumstances seem normal to them (please see article, Post-Traumatic Stress Disorder). 

   The second primary reason for anxiety is that some people have developed so much feeling of responsibility for loved one's that they too easily worry that any non-loving feelings within them could be dangerous to those they love (please see article, Obsessive Compulsive Personality and attend to the “responsibility fragmented individual” within that article).  Guilt can grow for such a person from having any self-centered thoughts.  Feelings of anger are especially difficult to tolerate for these responsible people.  Any hint in their thinking that they may have feelings inside them that might damage others makes them become anxious and worried.  They become especially tense if they fear their potentially hurtful selfishness or anger might become so powerful that it could leak out and be detected by others (please see article, The Crippling Effects of Worry). 

   The anxiety that derives from trauma in one's past bubbles up when their environment is not in their absolute control, or when others will not conform to their way of doing things.  This type of anxiety response is typically mixed with a fair amount of anger, and these people can become emotionally aggressive when life becomes stressful.  The second group, in contrast, typically tries to be kind and good all the time, but because no one is always kind and good, whenever their unkind and not completely good thoughts threaten to become conscious, they feel shame and worry about rejection.  This “good person” group also often worries about others, and they often come to realize that their greatest fear is loss (loss that occurs because they are “bad” or loss that occurs because others are free to leave or make mistakes).  For either of these groups, when something terrible happens that is beyond their control, their reaction is often depression and their anxiety is exacerbated.  They have been trying so hard to maintain things in perfect order, or to be as good as they possibly could be, that it simply does not make sense to them that something bad could happen to them.

   Thus, it is important to recognize how little control we really have and to understand that to be human at least partially means to be selfish, needy, aggressive, hurt, and sometimes fearful.  We can only do what we can do.  We can try to be our best and to help those that we love.  But we cannot be perfect.  We cannot always do everything right.  We cannot control how others do things.  We have to maintain humility about our frailty and our imperfection and we have to realize that we are merely small cogs in the giant machinery of life.  When we maintain a balanced view of our place in the scheme of things, and let others share in our imperfect humanity, we are much less likely to become overwhelmed with anxiety. 

   It is also important to discuss the chemical components of anxiety.  No one really knows the extent to which anxiety is caused by chemical changes in the brain or whether the brain’s chemistry changes when someone becomes chronically anxious.  If one can find some relief from disabling anxiety, it doesn't really matter if its cause is chemical or psychological.  No matter how you view it, it is a fact that there are brain chemistry changes concomitant with the experience of anxiety.  The psychodynamics behind anxiety are also a matter of fact, whether or not chemistry is involved.  The human emotional system works by certain mechanisms that make people react with anxiety to a history of traumatic interpersonal experience or responsibility taking beyond one's control.  There are certainly people who are more prone to anxiety at the chemical level, and they are more likely to respond with fear, an inability to trust, or a need to hide all selfishness or anger to avoid overwhelming levels of guilt.

   If you are experiencing anxiety, please breathe and try to relax.  Share your feelings with others whom you trust.  Let yourself be vulnerable with those you trust.  Try to recognize that you are just an infinitesimal being in a huge interpersonal world.  With effort, you might be able to get things to go your way, you might even be able to stay somewhat safe, but you can't truly expect to have any real control over anything or anyone but yourself.  You may care very deeply about others, and you may actually know what's best for them, but you will never be able to prevent them from making mistakes.  You should also realize, however, that most of the time, those mistakes won't cause horrendous disasters.  You must also realize that you are human and that us humans have selfish thoughts, even mean and angry thoughts, but only our actions can truly hurt others.  You don't have to be perfect in any way, not in hiding your imperfections and not in doing it all.  It's as simple as this, although it might not seem to be so, you need only be able to give and receive love and everything will be okay.  But that's not always so easy to do.  If you just don’t think you can beat anxiety, there's no shame in seeking help.  If you need to talk, there's no shame in seeking a psychotherapist.  If medicine might help, why hesitate?  The truth is, you need to feel good to be the loving person you need to be.  There is also another truth when it comes to anxiety.  Everybody gets it sometimes.  Reach out and you will undoubtedly find, as isolated and alienated as you might feel, you are definitely not alone.