Anxiety

 

What is it?

Anxiety and fear are emotions we can't live without. Fear alerts us to immediate dangers in our environment so we can quickly spring into action to manage the situation and keep ourselves from harm. Anxiety tends to be a more future oriented emotion. It informs us that there is something we need to prepare for, actions we can take now to ready ourselves for some future challenge or threat (a job interview, a test coming up, expecting your first baby).

Anxiety and fear are actually adaptive -- they are feeling states that give us important information about the world we live in so we can survive in the moment and even thrive in the future. For some, though, problems arise when anxiety stays on 'alert mode' for long periods of time or spikes uncontrollably in certain situations.

Our susceptibility to problems with anxiety comes from different places. Beginning at birth, some of us are born with more mellow constitutions and some of us seem to have more highly reactive nervous systems. After that, our environment, the nature of our attachment relationships, exposure to abuse and trauma, life stressors, substance abuse, and other physiological factors can also play a role in our susceptibility to anxiety problems.

States of anxiety can be very uncomfortable affecting our bodies, our thoughts, our feelings, and our actions.

 

Our Bodies

Physiologically, anxiety and fear ramp us up for a battle we anticipate is coming. Our heart rate and blood pressure increase. We may feel flushed or nauseous. We may sweat or tremble. Muscle tension, restlessness, fatigue, headaches, and sleep difficulty can be associated features. 

 

Our Thoughts

Our thoughts can take on an uncontrollable racing quality as our mind works exhaustibly to solve exaggerated problems. Our thinking can become unrealistic and distorted as our minds jump to conclusions with little supportive evidence or quickly assume worst case scenarios. Negative thinking tends to be the norm as we begin to expect, anticipate, and rehearse with negative self talk the worried outcomes we believe will come true.  

 

Our Feelings

Alongside racing thoughts, uncomfortable feelings can add to the negative experience as well. We may feel a sense of foreboding, dread, or doom. Triggering situations might lead to acute feelings of being trapped. Relatedly, we may experience strong impulses to flee or escape. Chronic worry may lead to worrisome feelings of insecurity and self doubt. We can start to lack confidence and belief in ourself and our abilities resulting in feelings of discouragement and shame. Spiraling down in this fashion can lead to feelings of depression alongside the anxiety we already feel. 

 

Our Actions

In an attempt to to manage and control the uncomfortable thoughts, feelings, and bodily sensations we have, we end up pulling away from whatever it is we think is the source or trigger of our fear or anxiety. This might mean disengaging from relationships, steering away from work or career challenges, or letting go of other previously meaningful life goals. The result is that we stop taking risks and shrink away from having a life worth living. We foreclose on the chance to have a more joy filled life. Through avoidance, we miss out on opportunities to actually work through anxiety arousing situations. We don't give ourselves chances to learn how to adapt, to tolerate, and to grow.

Ultimately, suffering increases as negative loops of anxiety and the ineffective control or avoidance strategies we rely on don't give us the relief we are looking for. Over time and without help, despair can set in and living a happy and valued life may start to feel impossible. 

 

Types of anxiety

Clinically significant anxiety can come in different shapes and sizes. What they all seem to have in common is a predominant feeling of worry and/or fear, a heightened and uncomfortable physiological/emotional/cognitive state, a sense of loss of control, a desire to avoid the discomfort, and a negative impact on life functioning. The following are some of the different kinds of anxiety people struggle with.

 

Generalized Anxiety

Generalized anxiety describes someone who is chronically on a high state of alert. Characterized by excessive worry about anything and everything, common features are: muscle tension and fatigue, difficulty with concentration, sleep difficulty, and restlessness. Generalized anxiety can pervade everything you do, potentialy interfering with functioning at work, at home, in relationships, or other areas of your life. 

 

Panic Attacks

Panic is the sudden rush of uncontrollable fear. The attacks typically include a strong physiological component: racing heart, chest pain, sweating, flushing, trembling, dizziness, nausea, shortness of breath. Uncomfortable thoughts and feelings are also associated with panic including: fear of dying, strong need to flee or escape the situation, feeling trapped/stuck, feeling a sense of 'unreality' about your experience (depersonalization), fear of going crazy, feeling shame. Panic can be especially troublesome for people because of its unpredictability. The panicked person begins to develop a fear of the fear itself and can quickly pull themselves away from living life at all in an attempt to shut down any opportunities for the panic to raise its ugly head again.

 

Specific Phobias

Specific phobias, unlike generalized anxiety, refer to fear and anxiety about a specific situation or object. Common ones include: situations (fear of heights, flying or closed spaces), animals (dogs, spiders, snakes, sharks), our bodies (fear or worry of contracting an illness or disease, worry about injuries), the natural environment (storms, earthquakes, water, lightning), fear of the sight of blood or needles.

 

Social Anxiety

Social anxiety is a relatively common type of anxiety focused around fear of embarrassment or humiliation. As the name implies this anxiety shows up in social situations where the person feels there will be evaluation or judgement -- for example: public speaking, work presentations or performances, going out with friends. The assumption is that the judgment will be negative and that major flaws will be exposed. In an attempt to avoid discomfort, people tend to limit themselves and their opportunities for living a fuller life.

 

Obsessive Compulsive Disorder

Obsessive-Compulsive disorder is an anxiety disorder that features intrusive, uncontrollable, and persistent thoughts, impulses, or images that bring intense anxiety. Examples include obsessions with dirt or germs, violent or horrific images, or fear of blurting our obscenities. Along with the obsessions, this disorder features compulsions (ritualistic behaviors or mental acts) whose purpose is to relieve or counter-act the anxiety associated with the initial obsession. Examples can include excessive hand washing or cleaning, frequent checking behaviors of light switches or locks on doors and windows, or uncontrollable collecting or hoarding behaviors. As you might imagine, the amount of time and energy dedicated to the obsessions and compulsions can hugely detract from living a happy life.

 

Post Traumatic Stress Disorder

Post traumatic stress disorder is a grouping of anxiety symptoms related to an overwhelming trauma (physical/sexual abuse, violent crime, rape, war/combat situations, natural disasters). Symptoms typically cluster around 1) intrusive, uncomfortable re-experiencing of the traumatic event (flashbacks); 2) organizing one's life in such a way as to avoid situations that remind you of the trauma; 3) emotional states around numbing, detachment, or disassociation; 4) negative and pervasive feelings of guilt, fear, or shame and 4) chronic, high states of anxious arousal (feeling on edge, tense, keyed up, on alert -- almost as though you are keeping careful watch so that you aren't traumatized again). Of course, these symptoms generate a lot of discomfort and keep people from living the full lives they used to have before the traumatic event.

 

getting better

There is real help for people who struggle with anxiety. Treatment interventions are focused around understanding the nature of anxiety, interrupting our avoidance strategies, and learning how to deal with anxiety sources head on. More than just forcing ourselves to experience anxious discomfort until we 'get used to it', it is important to re-frame anxiety as a normal and natural aspect of human be-ing (though uncomfortable) that can be experienced with less suffering if we allow ourselves to be with it with kindness and compassion.

Step 1: Understanding the Nature of Our Anxiety

It will be important to recognize what's unique to your anxiety. How do I experience it? For how long has it been a problem? What are the related thoughts and feelings and body sensations? Is it affecting my career, my relationships, my physical health? What seems to trigger it? Do I have a family history of anxiety? How have I been dealing with it so far? What seems to help? What makes it worse? What do I tend to give up or avoid to manage my anxiety? Having a better sense of your anxiety enables us to make a plan to respond. 

Step 2: Learning to Approach Instead of Avoid

With a closer look, we come to see that exerting so much of our emotional resources on trying to get rid of, avoid, or minimize anxiety is exhausting and ineffective -- what we resist, persists. Turning our focus on accepting what we cannot change (living with a certain amount of uncomfortable fear and anxiety) and then changing what we can (the way we relate to our anxiety, the way we care for ourselves/reach out for support while we are experiencing it) can go a long way toward easing our suffering. 

In addition, learning to 'bring our anxiety with us' as we turn toward the kind of life that is meaningful and important to us is enriching and fulfilling. Moving away from avoidance strategies and embracing an approach philosophy to life (and to the things that make us uncomfortable) is the key to recovery from anxiety disorders. While this sounds scary, I know with experience that in time we become less identified with our anxious self and have more room to experience life fully. 

Step 3: Understanding Anxiety and the Story of Our Lives

Making sense of anxiety given the context of our lives can also be helpful. There are ways that certain aspects of anxiety might be related to important relationships from our past, family of origin conflicts, or interpersonal conflicts today.

In addressing anxiety related to trauma or abuse, it is especially important to regain a sense of trust in others (the trust that was so tragically broken). Finding meaning in your story of survival and potentially reaching out to others with similarly painful histories can strengthen your recovery.  

Step 4: Learning Strategies to Deal with Anxiety Immediately in the Here and Now

Mindfulness exercises (exercises that help us focus on being in the present with acceptance and without judgement) can be helpful in learning how to be with and not avoid our uncomfortable anxious states. Mindfulness can help us be less judgmental of what we are going through. It can help by keeping us in the here and now instead of future tripping or obsessing on the past. Mindfulness strategies can help give us a certain 'distance' from our anxious self -- a distance that enables us to be more compassionate with ourselves, allow us to see that our anxiety is not all of who we are, and empower us to make choices to keep living brightly alongside our anxious thoughts and feelings.

Understanding how our anxious and avoidant cycles work can help us have a better sense of when and how to intervene and interrupt them. If we are aware of anxious and distorted self talk that frequently plays in the background, we can learn to address it more directly, gently challenging and reframing distorted and untrue thinking. We can then work on accepting and being with what we are feeling so that it lessens its unrelenting grip on us.

 

go after the life you want

If anxiety is something you are struggling with, I can help you assess just how anxiety operates in your life, how to quickly learn strategies to begin to ease related suffering, and how to refocus yourself on what brings you joy and meaning. I want you to go after the life you want. You don't have to allow worry, anxiety, or fear to get in the way!


How can I help? Schedule your first session or set up a free phone consultation.

Call 425.451.1620 or email joe@joebutlertherapy.com