Anxiety

It’s only human to feel anxious… Some of the time. Anxiety is a normal, if unpleasant part of life and it can affect us all in different ways and at different times. Anxiety can appear in different forms and at different levels of intensity. It can range in severity from a twinge of uneasiness to a full blown panic attack. Anxiety is something that all human beings experience from time to time when faced with situations that are difficult or threatening. Anxiety is part of our survival kit. It can be a helpful emotion as it can help in the preparation of events ahead as well as improving performance, but too much anxiety can be problematic. Anxiety can become so severe and intense at times that it becomes debilitating and starts to restrict daily routine and life as a whole. When it gets out of control, anxiety can quickly become as disabling as any chronic physical illness. Anxiety disorders are distinguished form everyday ‘normal’ anxiety in that they involve anxiety that is 1) more intense (e.g. panic attacks) 2) lasts longer (4 months or more) and doesn’t go away after a stressful situation has passed or leads to phobias that interfere with your life. You many have experienced overwhelming, unrealistic fears or worries, phobias, obsessive compulsive behaviours or post-traumatic stress reactions that have stopped you living your life as you would like to. 1 in 4 people will experience some kind of mental health problem in the course of a year ( Mental Health Foundation 2014). Anxiety is the most common form of mental distress in the U.K. today. Anxiety is made up of three elements 1) the physical sensations you experience – heart racing, sweating, trembling or shaking, chest pains or tightness in the chest, breathlessness, feeling of choking, nausea, upset stomach, dizziness and feeling lightheaded or faint, feeling like you are losing control or going mad, feeling numb or tingly, feeling hot or cold, feeling like you will die …… and many more. 2) The emotions you have whilst experiencing anxiety and 3) the thoughts that go through your mind. When anxiety gets out of control it means something isn’t working properly in our lives. It could be because one or more of our essential needs aren’t being met or in balance or because our innate resources which were designed to help us meet our needs aren’t functioning as they should for a variety of reasons. There can also be specific triggers e.g. bereavement, divorce, moving house, surgery, illness and violence (there are many others but these are typical and frequent ones). Some people who experienced a particularly traumatic incident during their childhood, although forgotten in their conscious, rational, e.g. a child who was frightened during a thunderstorm may grow into an adult with an irrational fear of storms. There is often not one primary cause. Anxiety problems can be brought about by a variety of causes operating on numerous different levels – hereditary biological, family background and upbringing, conditioning, recent stressors, self talk and personal belief system, ability to express feelings and so on. There are many different levels on which to understand the causes of and means of recovering from anxiety disorders. The idea that anxiety disorders are ‘just’ a physiological or psychological disturbance neglects the fact that nature and nurture are interactive. (Biological disturbances may be disturbances). A variety of strategies dealing with several different levels, including biological, behavioural, emotional, mental and interpersonal is necessary for a full and lasting recover. ( Multidimensional approach). LONG TERM PREDISPOSING CAUSES - Hereditary – learned behaviours – inherit a general personality type that predisposes you to be overly anxious. - Childhood circumstances – social conditioning. - Parents/Carers/Family/Significant others – communicate an overly cautious view of the world as threatening and dangerous. - Overly critical and set excessively high standards for self. - Low self esteem and low confidence levels, limited self belief, self critical and non-assertive = increased anxiety levels. - emotional insecurity and dependence - Parents/family/significant others suppress your expression of feelings and self assertiveness. - Cumulative stress over time – e.g. unresolved psychological conflicts, marriage or health problems, large cumulative number of life events. BIOLOGICAL CAUSES - Panic attacks - O.C.D. ( Obsessive compulsive disorder) - Medical conditions that can cause anxiety SHORT TERM TRIGGERING CAUSES - Stress, significant personal loss, significant life change including illness or an accident, stimulants and recreational drugs, trauma, simple phobias. MAINTAINING CAUSES - Avoidance of phobic situations/places - Anxious self talk ( negative, critical voice ( monkey chatter), low self esteem, low confidence levels, non-assertive behaviour). - Mistaken beliefs – ( not facts or truths – just thoughts/opinions. - Withheld feelings – denying feelings of anger, frustration, sadness etc., can contribute to a state of ‘ free floating’ anxiety, when you feel vaguely anxious without consciously knowing why. - lack of assertiveness ( passive people often prone to anxiety - Lack of self nurturing skills – ( I’m not worth it, parental abuse and deprivation). - Stimulants and other dietary factory ( e.g. caffeine, nicotine, alcohol, drugs) - High stress lifestyle - Lack of meaning or sense of purpose ( often there is a relief from anxiety when a person comes to feel that their life has meaning, purpose and a sense of direction. THE FIGHT OR FLIGHT RESPONSE Long ago when our ancestors were still living in the wild, their very survival depended on being ready to react instantly e.g. if a wild bear charged out of the undergrowth or a hostile tribe appeared. As soon as we sense a threat a chain of bodily events is triggered to help us cope. The following happens instantaneously – our muscles tense ready for action, our blood pressure goes up to increase the circulation to our muscles and heart, which beats faster to cope with the unexpected increased demands on it. We breathe faster to speed up the time oxygen takes to get into our blood and that makes our chest tight and our bodies tremble. In order for as much blood as possible to reach our limbs our digestion is interrupted, making our saliva dry up. We sweat to try and cool ourselves. Our bodies are flooded with ‘stress’ hormones that enable all these responses to happen and, as a result, we immediately flee ( flight response) the wild bear or fight the unwelcome tribe. It’s easy to react, rather than respond to life events due to something called ‘emotional hijacking’. Our brains have two distinct halves and each half understands the world very differently. The emotional ‘ right’ brain is our primitive ‘mammalian’ brain and contains a very small but powerful structure known as the ‘amygdala’. It communicates with us through our feelings, emotions and through our imagination. Information enters our right brain first – the amygdala acts as our alarm system and checks in a second whether we need to activate our ‘fight or flight’ system. Our emotional brain has the ability to switch off rational thought for a good reason – if there was a bus hurtling toward you in the road ( or the wild bear) there would not be time to make a list of all the options – you need to react immediately. Our emotional brain temporarily disables our rational ‘left’ thinking brain whilst it turns on the fight or flight system. It floods the body with adrenaline and the chain of physical and emotional reactions kick in to make you jump our of the way of the bus. The emotional brain only sees things in black/white terms – either ‘ everything is o.k’ or ‘everything is not o.k’. Our emotional brain does not differentiate between being chased by a bear or bus or everyday smaller, not dangerous events. For this reason we do not want the emotional brain to be fully activated 24/7 in our everyday life. We, of course, need our emotions but we do not want them to take over control. Your amygdala doesn’t care if you live permanently in an anxious state of fight or flight. The emotional brain and black/white thinking is all encompassing , self focused, jumps to conclusions, blames, exaggerates feelings, catastrophises and has a perfectionist tendency. So when the amygdala is in full flow it sends a cascade of signals to the neocortex and inhibits it’s ability to understand and analyse situations forcing us into emotional black and white, all or nothing thinking that prevents our rational brain from considering other options. We can feel anxious even when we’re undergoing a positive change, such as getting promoted, moving into a new home or going on holiday. Anything that breaks us out of our comfortable or not-so-comfortable, familiar routines sets off the alarm in the amygdala. The old brain is alerting us to the fact that we are entering territory that has not been mapped or surveyed, and that danger may lurk around every corner. Fortunately, in counselling and/or therapeutic coaching, after exploring and understanding your anxiety and with practice there are many tools to overcome this chain of events and to learn how to stop the emotional brain hijacking the left, rational one.