Whether you’ve experienced butterflies in your stomach or the “I’m going to puke” panic before a presentation in front of the class, we have all dealt with some form of nervousness or anxiety. This beginner’s guide to anxiety will discuss what exactly anxiety is, where it comes from and how to relieve your anxiety symptoms.
What is Anxiety?
Anxiety is simply a stress response within the body. Your brain is always trying to keep you safe and alive. It is continuously and unconsciously scanning your environment looking for threats. It will compare current situations to past situations looking for “evidence” that it might be a threat.
This is what your brain is supposed to being doing for you. The problem is…
Sometimes your brain gets it right and sometimes it doesn’t.
Anxiety is really just a bodily response to an imagined or real threat. Anxiety comes in many shapes and sizes, ranging from just minor uneasiness or worry, to full blown debilitating panic attacks.
What is happening in your brain and body when you’re experiencing anxiety?
Neuroception
Neuroception is the unconscious process that describes how neural circuits in your brain distinguish whether something is dangerous or safe. This is programmed into our DNA as an early warning system.
This information is picked up through the senses. Which might explain why you just “get a bad feeling” about certain people or situations. Our brain and body are picking up on a significant amount of information around us to help us assess threat.
Several different parts of your brain are being activated when you’re feeling worried or anxious. Here are the main ones:
- Amygdala: An almond shaped structure that is found in the limbic system, the region that regulates emotions. The amygdala acts as our early warning system. It plays an important role in controlling our ‘fight or flight’ system, fear responses, and the processing of emotions. It is involved with the solidification of long-term emotional memories.
- Hippocampus: Involved in the formation of new long-term memories, especially facts and events. It is associated with learning and emotions.
- Thalamus: Interprets all of the sensory information and ultimately is responsible for sending signals to other areas of the brain to release adrenaline and stress hormones like cortisol, in response to a real or perceived threat. It is involved in motor, arousal and mood functions.
If our body views our current situation as safe, the body will maintain homeostasis and a calm state. However, if at any time our body perceives a threat, our brain goes into defense mode, or ‘Fight or Flight.’
Fight or Flight
‘Fight or Flight’ is the process in which your nervous system switches from the parasympathetic nervous system (rest and digest) to the sympathetic nervous system.
A specific chemical cocktail, including cortisol and adrenaline, is released into your system to help you fight or flee a dangerous or threatening situation.
What happens during ‘Fight or Flight?’
Your heart starts pumping faster and more blood is pumped throughout the body.
Around 70% of your blood leaves the brain and moves into your arms and legs to prepare to fight or run.
Because so much of the blood has left your brain (and you don’t need critical thinking skills in the middle of a fight) your thinking becomes foggy and impulsive.
The bronchi in your lungs dilate to let in more oxygen and your breathing rate increases.
Your senses become heightened. You can see more clearly and hear better.
Your digestion and sex organs slow down (these are non-essentials during a fight for your life).
Your muscles tense and your muscle strength increases.
Your spleen pumps out white blood cells and platelets to prepare for possible injury.
When your ‘Fight or Flight’ system gets it wrong
In an actual life threatening situation, your sympathetic nervous system does everything it is supposed to do in order to help you survive. The problem is thatyour body often detects threat that is not there.
Think of all the outside stimuli that you are being flooded with each day. Politics, the news, social media, TV shows, arguments with your boss or partner, or the morning commute.
Your brain misinterprets many of these events as threatening, even when they aren’t. But our body still gets a hit of adrenaline and cortisol.
Usually after a ‘fight or flight’ event, the chemical cocktail that has gone off in your body dissipates in 20 minutes to 30 hours, depending on the situation. Then your body flips back into ‘rest and digest’ mode and the body functions return to baseline.
But if your body continues to feel real or perceived threats, after a while, your ‘fight or flight’ button gets turned on and stays on. It becomes very difficult to relax or feel calm. This can lead to more chronic levels of anxiety and even anxiety disorders.
Anxiety vs. Anxiety Disorders
Feeling anxious is a part of human life. Everyone will have symptoms of anxiousness, worry or nervousness at some point in their lives. Some will struggle with these feelings far more than others.
Just because you feel anxious sometimes or are prone to worry (I see you fellow worry warts!) does not mean that you have an anxiety disorder.
If you go through a life change or difficult situation that causes you to feel anxious for awhile (losing a loved one, losing a job, break-ups, birth of a child etc) this does not mean you necessarily have an anxiety disorder.
In order for anxiety to turn into an anxiety disorder the following criteria have to be met:
Your anxiety has to be excessive (think almost everyday for a large portion of the day).
It has to last for more than 6 months at a time.
It has to affect your daily life, making it difficult or impossible for you to carry out your daily responsibilities – school, work, relationships, parenting etc.
Any medical or substance related conditions need to be ruled out as the cause of your anxiety (ex: thyroid issues, uncontrolled blood sugar issues, alcohol addiction, caffeine overload).
In addition you have to meet the specific symptomology for each specific type of anxiety disorder.
What are the different types of anxiety disorders?
Generalized Anxiety Disorder
With this type of anxiety disorder, it can be difficult to pin down a cause or trigger for your anxiety.
People with generalized anxiety disorder tend to feel a general uneasiness that they carry throughout the day.
They might experience restlessness or often feel on edge.
Symptoms tend to be more general – easily fatigued, sleep issues, difficulty concentrating, moody or irritable, muscle tension or aches and pains
Panic Disorder
Panic disorder is characterized by having recurrent panic attacks. A panic attack is an unexpected, intense moment of fear or discomfort, where you may feel many of the following symptoms:
Heart palpitations/pounding heart or increased heart rate, chest pains
Sweating, trembling or shaking
Feeling like you can’t breath or are choking
Feeling nauseous or stomach aches
Feeling dizzy, light-headed or faint
Having the chills or hot flashes
Feeling numbness or tingling sensations (often in face, hands and feet)
Feeling like you’re detached from yourself (out of body) or what is going on around you isn’t real
Fear that you’re going crazy or are dying
(Please note: many of these symptoms can also point to more serious medical conditions or emergencies, if you are experiencing an event like this for the first time, it’s a good idea to get yourself medically checked out.)
Panic attacks need to happen more than once and need to be accompanied by a persistent worry about either having more panic attacks or worrying about the consequences of having more panic attacks, in order to be considered panic disorder.
Specific Phobias
A specific phobia is an intense and irrational fear to a certain object or situation.
Common phobias include: thunder and lightning, spiders and snakes, heights, or enclosed spaces (claustrophobia).
Social Anxiety
Social anxiety is a fear of one or more social or performance situations, where a person is exposed to unfamiliar people or possible judgement and ridicule by others.
The exposure to these people or events almost always provokes anxiety in them.
People with social anxiety often avoid spots where they feel they might be anxious or distressed.
It significantly impacts a person’s routine or day-to-day life.
This is different than being shy or slow to warm up. Remember, disorders are debilitating and long lasting.
Post-Traumatic Stress Disorder (PTSD)
While PTSD is no longer considered a specific anxiety disorder, the two often go hand in hand.
PTSD happens after a person is exposed to death, threatened death, actual or threatened injury, or actual or threatened violence by directly experiencing it, witnessing it in person, indirectly – learning that a close relative or friend was exposed to it, or repeated indirect exposure of others (usually these are professionals on duty – fireman, first responders, police, therapists etc)
PTSD causes intrusive symptoms including nightmares and flashbacks.
They may feel numb or detached from self.
People with PTSD are often spending a lot of time trying to avoid reminders of the event, including avoiding places or people and may be resistant to talking about what happened or how they feel.
They often experience intrusive or negative thoughts and feelings about themselves and others, experience anger, fear, guilt, or shame.
They may be easily reactive or irritable, have angry outbursts, behave recklessly or self-destructively, including having suicidal thoughts and attempts.
They tend to be hyper-vigilant, easily startled and have trouble concentrating and sleeping.
Often PTSD can coincide with other disorders like depression or substance use disorders.
What about Obsessive Compulsive Disorder (OCD)?
There is a lot of debate whether this disorder should be classified as an anxiety disorder at all. In the most recent DSM-V (the mental health diagnosis bible), they chose to classify it by themselves, instead of lumping it with the other anxiety disorders.
There is recent research that OCD involves different parts of the brain than traditional anxiety, so I won’t say much more about it here.
Feel free to check out The International OCD Foundation to learn more.
The Pros and Cons of Receiving a Mental Health Diagnosis
Pros of Mental Health Diagnosis
People who feel worried that symptoms might be ‘just in their head’ or might be afraid they are ‘going crazy’ may be validated by an actual diagnosis.
It can give you and your doctors/therapists/psychiatrists a similar framework to work from.
It can provide you with consistent language to help explain to family, friends and loved ones what is going on in your brain and body.
The Cons of Mental Health Diagnosis
Unfortunately, mental health issues in this country still carry a lot of stigma. People often feel like they have a scarlet letter attached to them if they’ve been diagnosed. This can prevent them from seeking out services to help manage symptoms.
A diagnosis becomes part of your permanent medical record. Technically, if you have been officially diagnosed with a mental health disorder, you are supposed to list it as a pre-existing condition. This could possibly impact future jobs or the ability to obtain certain insurances (life insurance).
People sometimes take on their diagnosis as their entire identity and it ends up holding them back from reaching their full potential.
Mental health diagnoses don’t consider any other factors that might be making your mental health worse, including situational factors, relational factors, trauma experienced, income level, racial inequalities or injustices, ability to receive adequate care, housing etc. Often these are the root cause of many mental health related issues including anxiety.
What are the causes of anxiety?
Situational
Holding your breath/hyperventilating, extreme or prolonged stress, death of a significant person, birth of a child, parenting, loss or change of job, marriage, divorce or break-up, money issues, housing, trauma
Biological
Thyroid issues, heart abnormalities, blood sugar issues/diabetes, chemical imbalances, parasites, bacterial infections, vitamin deficiencies, poor gut health
Substance-related
Caffeine, sugar, alcohol, drugs (prescribed or illegal)
Cognitive Distortions
All or nothing thinking, catastrophizing (thinking the worst will happen), overgeneralizing, jumping to conclusions, making things personal, blaming others, ‘I shoulds’
While you cannot entirely get rid of your anxiety, (remember it is there to keep you
safe) there are several strategies you can use to lessen your symptoms, especially if anxiety is affecting your day-to-day quality of life.
Ways to Lessen your Anxiety
Acceptance
Acknowledging that you have anxiety and that you struggle with it, is the beginning of learning to accept it as a part of your life. It’s kind of like the pink elephant experiment. If you tell yourself not to think about the pink elephant over and over again, all you end up thinking about is the pink elephant. The same thing goes for anxious thinking. What you resist, persists.
Practice Mindfulness
Mindfulness is the ability to be fully present in the moment. Taking time to enjoy the here and now without worrying about the future or replaying the past. This is a practice in paying attention to the little things that go on around you every day
Meditation, Relaxation and Breathing Exercises
Studies have shown over and over again that a meditation practice can significantly improve your mental health. Don’t over-complicate this. Start by inhaling through the nose and exhale through your mouth (like you’re blowing through a straw). Make sure your exhale is longer than your inhale. Do this 10-15 times. If you’d like more direction or want to follow along with someone else, there are plenty of videos on YouTube to try.
Exercise
Exercise is an important part of any healthy lifestyle, but can be especially helpful in treating anxiety. Start small. Try a 10 minute walk each day and work up from there.
Set Boundaries
Sleep
Depending on your circumstances, getting the recommended 7-8 hours of sleep might seem impossible. Make sleep a priority. Getting enough sleep can help your body switch from ‘fight or flight’ to ‘rest and digest’ mode, lower cortisol levels (stress hormones) and repair your body.
Feel Through Your Feelings
Are you someone who tends to shove down your negative emotions instead of dealing with them? This can be adding to your emotional stress load and causing you more anxiety. Allow yourself to sit with uncomfortable feelings for a few minutes before moving onto something else to distract yourself. Or try a good cry if you need to.
Journaling
Many people find that regular journaling improves their mental health. Start a gratitude journal, list out 3 things that you are grateful for each day. Or try “brain dumping.” List out everything in your head, everything you have to do, everything that is bothering you. Often people feel better just by getting it out of their head and onto paper. This is a good practice to try if you can’t sleep at night because your brain won’t shut off.
Focus On What You Can Control
Rarely can we control everything in a given situation, but we can always control something. Try to let go of the things that you can’t control and focus on what you can. For example, you can control your attitude and your actions.
Decrease or Eliminate Caffeine, Alcohol and Sugar
All three of these tend to be big anxiety triggers for a lot of people. Observe how low or high your anxiety is right after/the day after consuming these and decrease or eliminate accordingly.
Find a Good Therapist
A therapist can help you identify the root cause of your problems, recognize anxiety triggers and teach you better coping skills, all within the context of a safe and supportive environment.
Medication
While medication shouldn’t be your first or only line of defense against anxiety symptoms, it can be helpful for certain people. Talk to your doctor or a psychiatrist to learn more about your options.
In summary, everyone deals with anxiety in some shape or form throughout their lifetime. If you feel that your anxiety is becoming difficult to manage on your own, reach out to family, friends, a spiritual leader or a therapist for support.
If you are interested in working together, please contact me to learn more.
Megan Weber LPC is currently providing in person and online video therapy sessions, serving Neenah, Appleton, Oshkosh and the surrounding Fox Cities area.
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