What Is Anxiety?
Everybody experiences anxiety sometimes – it's hard-wired into us.
Sometimes it's even helpful – a little bit of anxious arousal can often give us an edge and push us into performing better. That's especially so when physical action is needed. A football player needs to be hyped up to win!
The football player probably wouldn't call it anxiety, but it's the same basic process – the fight or flight response in anticipation of a challenge.
With the “fight or flight” response a person will become more alert and reactive, but less able to think clearly about complex issues. These things will happen:
- heart rate and blood pressure increase
- muscles tense up
- breathing becomes faster and shallower
- blood flow goes to the essentials for action – heart, lungs, skeletal muscles – and away from the functions less essential to dealing with the immediate threat: higher brain centres, reproductive system, digestive organs, skin.
This response helps us deal with threats, especially physical threats – if you're about to be hit by a car, you need to get out of the way fast.
Where it goes wrong – and becomes anxiety rather than a useful response – is when this response, the basic fight or flight response, becomes chronic and ongoing even when there is no real threat. At this point we have chronic stress.
Stress and anxiety
Chronic stress is not anxiety, but it's on the way. The physical symptoms of the fight or flight response persist and morph into physical disorders:
- high blood pressure
- headaches and back pain from chronic muscle tension
- digestive problems from lack of blood flow to the digestive organs
Chronic stress has other less obvious but more serious effects. When your adrenal glands respond to an ongoing threat they produce cortisol, whose job is to direct the resources of your body towards dealing with the threat, and away from doing all the things that keep you healthy on a day to day basis. Like a country at war whose citizens have to make do with food rationing, your body can't function optimally under conditions of threat.
Cortisol affects digestion, sexual & reproductive function, immune function, tissue repair, and brain function. Whether or not stress is the cause, it's certainly considered a chief suspect in a whole range of medical problems.
Stress can cause or aggravate:
- ulcers, colitis, diarrhoea and other disorders of the digestive system
- asthma, bronchitis, and chronic respiratory problems
- infertility – failure to ovulate in women, impotence in men
- high blood pressure and other cardiovascular problems
One of the most insidious effects of cortisol, and chronic stress, is its effect on inflammation. Cortisol suppresses inflammation – and since modern research has shown inflammation to be implicated in just about every medical problem you can think of, from overweight to auto-immune conditions such as fibromyalgia, arthritis, allergies, and even to aging – you might think cortisol would be helpful to all these conditions. Not so!
Inflammation is part of your body's way of healing an injury and dealing with infection. If inflammation is suppressed, you become more susceptible to infection.
There's an even more serious problem with too much cortisol in the system. It begins to lose its effect – and your adrenals need to secrete more and more to get a result. The delicate feedback mechanism is disrupted, and the end result is that inflammation tends to get worse as the stress continues.
How is anxiety related to stress?
When we talk about stress, we mostly refer to physical problems – the way your body reacts.
Anxiety, on the other hand, tends to refer more to the emotional and mental aspects of the “fight or flight” response – our experience of facing a threat. Make no mistake though – anxiety has physical symptoms that are more or less the same as the stress response:
- fast, shallow breathing – and a sense of not getting enough oxygen
- excessive muscle tension, maybe experienced as “the shakes” or general jitteriness
- “butterflies in the stomach” - with or without nervous diarrhoea and problems with digestion
- changes in skin temperature and colour – cold hands and feet, blushing or feelings of heat; excessive perspiration
- hypervigilance and inability to sleep
- cognitive problems – inability to concentrate and remember, impaired problem-solving.
Emotionally, anxiety is on the “fear” continuum – anything from pervasive worry, to general apprehension or dread. Usually we use the term “anxiety” to refer to this emotional state – it's what most of us think of when someone is referred to as being “anxious”.
However, the cognitive aspects of anxiety – the thought patterns - are the most important, if we want to understand what is anxiety, what causes anxiety, and how to overcome anxiety. On the other hand, these cognitive aspects are often the ones we are least aware of, at least until we begin to look for them.
Usually, anxiety is associated with fears of possible future events, rather than fear of a current threat – but the imagining of the future threat is experienced as though it is here and now.
Albert Ellis, the father of Rational Emotive Therapy (RET - the first type of cognitive behaviour therapy, or CBT) referred to this tendency as “awfullizing”.
Others call it “catastrophising”.
Both expressions describe very well what goes on in the head of an anxious person!
The good news is that once you realise this, it becomes possible to change it and to overcome your anxiety. Changing how your mind works is not at all easy, though, and this is where it really helps to follow a tried and tested process.
Is anxiety normal?
Yes, anxiety is normal – in the sense that we all get anxious sometimes.
When the first human ancestor began to plan for the future, he or she also began to anticipate possible negative consequences and events. It was a brutal, uncertain world in those days, and it's amazing, when you think about it, that anxiety was less of a problem then, than it is now.
How do we know this? Well, we can't be absolutely sure, of course, but in the few remaining communities of indigenous people living in the wild, anxiety has never been noted as a problem. In that situation, people are too busy dealing with the actual threats and challenges of day to day living.
This gives us another key to overcoming anxiety – constructive action can be a great help.
What if your anxiety is about non-specific or non-realistic possibilities? (Most anxiety is!)
…..the very task of developing a plan and taking action on it will give a message to this part of your mind that you are dealing with the problem, and the more you do this, the more confident and empowered you will feel.... these states are great anxiety antidotes.
(if this sounds too simple, don't worry – there are steps you can follow to make it easy and foolproof.)
Fritz Perls, the father of Gestalt Therapy, described anxiety as “excitement with a breathing constriction”. In other words, heightened energy or arousal in response to a challenge or threat is normal and healthy – but when a person in that situation feels that they have to inhibit or hide that response, the result is anxiety.
So yes, anxiety is normal – but that doesn't mean it's healthy for us!
Our era has been described as “the Age of Anxiety” - anxiety has become a pervasive problem. Anxiety is the most common mental health problem in most western countries, followed closely by depression. We don't have accurate statistics, but it's been estimated that 40 million adults in the USA suffer from some sort of anxiety disorder – and that's not counting those of us who endure some level of sub-clinical anxiety.
Our way of life tends to breed anxiety.
Yes, we have ongoing pervasive and impending threats to our well-being – nuclear catastrophe, financial crisis, ecological disaster, terrorism. But – humans have been bred to cope with threats to their survival – we are the products of ancestors who managed to do it superbly well. Compared with the general lot of those ancestors, for most of us today our lives are safe and comfortable.
So why has anxiety become such a problem?
The answer lies mostly in our minds, for the following reasons:
Social expectations have become more and more important as civilisation becomes more complex – so we learn to inhibit our natural responses to events. This is not always a bad thing – it's what has allowed us to develop a civilised society. But it has its downside when taken to extremes, as all good things do, and the downside is the loss of freedom and spontaneity, and over-suppression of our natural impulses.
We are not taught good mental habits – living in the past and the future, which we cannot change, we lose the sense of being present in the moment. The antidote to this is the development of Mindfulness. There are many different methods to develop mindfulness – find one that appeals to you. Mindfulness is one of the best ways of overcoming anxiety, no matter whether the anxiety is mild and occasional or severe and chronic.
We have other bad thinking habits – it's not too hard to identify and change these, if we go about it properly.
These bad thinking habits can be challenged, and this is the focus of Cognitive Behaviour Therapy (CBT) – one of the psychological therapies found to be very helpful in overcoming anxiety.
Some people find CBT enough to relieve anxiety completely. For others, though, a mental focus on its own does not work very well, and they do better with a comprehensive approach that includes dealing directly with the physical aspects of anxiety.
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