Ask our therapist: All about anxiety

With a mental overreaction, you are telling yourself through your mental processes that you are in grave danger when you are not.

You might be thinking “I don’t tell myself anything” “I wake up with anxiety, I haven’t even thought of anything” or “when I worry or think of bad things that could happen, they are possible, it is not irrational”

All I can say to these thoughts is that if you are having a physical “life or death” reaction to something that you are simply thinking about, and you are not literally in “a life or death” situation, then it is, in fact, an overreaction.

Physical Overreaction

One of the scariest things about anxiety is the physical symptoms, and understanding what is going on inside your body is a tremendous aid in reducing that anxiety. If you are experiencing a “life or death” feeling, then your brain will look for an explanation when the symptoms arise. If there is no lion about to eat you, then the brain will come up with something else, for instance, “my chest is tight, there’s a pain, I can’t breathe, it must be a heart attack or COVID19”, “I feel dizzy, I can’t think or focus, it could be a stroke or tumour”, “ I’m sweating and trembling, something serious is wrong with me”. There are many other, what appears at first glance to be plausible, explanations. We can get even more carried away and think “was it that text I sent yesterday, have I offended her?”

When you know why you have muscle pain, shaking, headaches or sweating, you can begin to counteract your panic about your physical symptoms. Knowing that your dodgy tummy or nausea is linked to anxiety helps inform you that it’s time to do something to reverse this physical state. When the brain is in a state of panic or anxiety, the centres of the brain that are responsible for focus, problem-solving and concentration are impaired so that your survival part of your brain can dominate to keep you safe.  This can make you feel spaced out, frustrated and confused.

Other functions not necessary for immediate survival are also dialled down so that energy and resources can go to the heart, lungs and muscles. These include physical repair, so cuts or injuries. Secondary to immediate danger is fighting infection, so the immune system is suppressed leaving you more vulnerable to viral, bacterial and fungal infections. I see a lot of people with IBS and I immediately begin investigating their anxiety and stress levels. Everyone I have encountered with IBS has some form of worry, stress or anxiety.

The body is only meant to be in a state of “fight or flight” for a short period of time until the danger has passed because it is physically taxing on the body’s systems. However, constant exposure to stress hormones such as cortisol and adrenaline that initiate these physical changes can cause longer-term problems. Sleep, libido and energy levels can be affected with long term stress or anxiety.

While short term stress reduces inflammation, long term exposure to the stress hormone cortisol can cause a cascading inflammatory response in certain areas of the body. This can account for increases in occurrences of IBS, eczema, asthma, cardio-vascular problem, rheumatoid arthritis, memory loss and a number of stress-related diseases such as Addison’s disease and Cushing’s disease.

Situation: You are driving to the airport in a taxi and you hit a traffic jam.

A: Activating Event           

You have a thought of missing the plane

B: Your Belief         

• I would like to catch the plane; but accept I may miss it. It is out of my control.
• If I miss this plane it will be bad but not the worst thing ever to happen to me.
• I would find it really difficult if I missed this plane, but I would cope,

C: Consequence

Slightly frustrated and concerned.

This is what we call a rational belief. It recognises that you are in a negative situation and it is appropriate to feel negative. It is in line with the real world, its truthful and it makes sense. It recognises that once stuck in a traffic jam, then you are jammed. It keeps the ‘badness’ of the situation proportional i.e. it is a negative situation, however, there are worse situations to be in. It also acknowledges your emotional and physical robustness to tolerate such a negative situation.

Common irrational thinking: “I must get to sleep or I won’t function tomorrow. What if I get coronavirus, I mustn’t get it or I will end up nearly dying and then not be able to get on a ventilator. The economy is going to crash and no one will have jobs. I can’t bear to be locked down and not see people I want to”

Other forms of anxiety arise from a fear of negative judgement, usually from usually whose opinions matter to us. It could be friends, bosses, parents or people out and about. Everyone is different from whom they seek approval from.

Wanting approval and feeling comfortable in social or “performance” related situations is normal. Saying you must have that approval, or must not look stupid, must not be rejected or must meet expectations will create a sense of pressure in your mind. The brain interprets this pressure as a threat then responds with the emotion of anxiety. With anxiety then comes the release of stress hormones such as cortisol and adrenalin and you feel the physical symptoms, such as shaking, sweating, butterflies and inability to think of what to say.

This photograph stirs up so many uncomfortable memories that include avoiding presentations at university and then at work. It wasn’t until my 30s that I overcame the incident when I was eight-years-old in assembly and got stuck on what I was reading. The headteacher was nearby and after a few excruciating minutes came to help me with the word I couldn’t read. The rest is a blur.

Behaviours

Behaviours that tend to occur when someone is anxious are usually unhealthy because they reinforce the cycle below. They do this by encouraging more thinking errors and increasing anxiety.

Procrastination, is an avoidance technique, of putting off what would serve you better doing now, till later.

Pure avoidance such as not going to social functions, or leaving the house is quite common to avoid the discomfort. Avoiding speaking up so as not to say something stupid is also avoidant behaviour.

Using behaviour to feel better

To eliminate anxiety by facing the things that cause anxiety is ultimately the only way to overcome it. This exposure can be gradual and/or with the help of a professional. Some people have managed to face their fears on their own by sheer determination and “faking it until they make it”.

Understanding anxiety and how to begin tackling it is the first step to not only feeling better but getting better. I have only given a brief overview; however, hopefully, you got some helpful insights. Please drop me an email if you have any questions and I will do my best to answer them.