What is Anxiety? How can we cope?

By Jimmy Warden

After reading books and doing additional research on the topic of anxiety, I’d like to say that is seems to be a trending topic in today’s world. There has been research done by the Anxiety and Depression Association of America that shows 40 million people over the age of 18 are affected by anxiety in some form, including, but not limited to, General Anxiety Disorder, Panic Disorder, Social Anxiety Disorder, Specific Phobias, Obsessive Compulsive Disorder, Major Depressive Disorder, Persistent Depressive Disorder, and Post Traumatic Stress Disorder. Additional data from the ADAA indicates that 25.1% of children from ages 13-18 are also affected by anxiety. Not to mention there are also a few examples of life’s “traditional anxieties”, such as job interviews, moving to a new city or state, or first dates. This is why anxiety can seem like such an overwhelming concept. It’s hard to get a thumb on anxiety when there is so much uncertainty around what it is, let alone how we can cope with it. However, once we have an understanding of what it is, we can recognize it, and use helpful coping mechanisms to bring us back to the equanimity we yearn for.

According to Faith Harper, the word anxiety can be traced back the Latin root “anxius” which means “to choke”. That is also a physical symptom a person could experience when experiencing anxiety. Believe it or not, anxiety manifests to protect us from what our mind and body detect as “danger”. Often times this is why individuals get nervous trying something new for the first time. It is foreign to them and they don’t know how to go about what is in front of them, so they have a few options. Fight, flight, or freeze. Regardless of the choice we make, there is anxiety that is present before the decision is made.

Anxiety can be triggered by thoughts, emotions, memories, or visualizations. When we have an anxiety provoking thought, emotion, memory, or visualization, there are three stress hormones that release into our body to “fight back”. First, there is epinephrine (aka adrenaline) that is shot through our spinal cord into our Central Nervous System (CNS), which activates stress hormones to combat the anxiety we’re facing (i.e. “fight or flight” hormones to move into the anxiety or escape it). According to Amit Sood, M.D., who is also the chair of the Mind Body Initiative at the Mayo Clinic, epinephrine is responsible for the instant increase in your heart rate when you feel anxious and the narrowing of your focus. All of those times you partook in some risky behaviors and felt your heart pumping, but you were still extremely focused? That was epinephrine taking over your body.

Norepinephrine is also released through the CNS to send blood to the muscles in our body that need to be activated to partake in one of the aforementioned behaviors. This is a reason why your face might get red during an argument or your fists clench when you’re ready to fight. Norepinephrine also increases focus, attention, and heart rate to prepare the body for action. Kind of like a “backup” to epinephrine, according to Sood.

A few minutes later, cortisol is released to regulate blood pressure and suppress the immune system to focus energy towards the anxiety the mind and body are dealing with. It also suppresses other functions, such as reproductive drive and digestion. The “kicker” with cortisol is that it’s continually released throughout the body any time we “stew” or “overthink” because we’re still in “stress mode”. When this happens, chronic stress and fatigue are often coupled with it because the body is constantly fighting the threats it is perceiving. This is why people who have chronic stress could have other health impairments such as high blood sugar and high blood pressure.

In the brain, anxiety can take the form of a phobia we have, a traumatic memory from our past, a pessimistic viewpoint of our future, excessive worry about the future or the present (creating a need for either to be ideal), hyper self-awareness and self-consciousness (creating a need for perfection), obsessive or compulsive behaviors (biting nails or overeating), self-doubt (negative self talk), or a feeling of losing it. In the body, it might feel like or look like, trouble falling asleep or staying asleep, muscle and neck tension, chronic indigestion, stomach pain and/or nausea, increased heart rate, pulsing in the ear (like you’re feeling your heartbeat), numbness in extremities, sweating, weakness, shortness of breath, dizziness, chest pain, seesawing feeling of hot and cold (almost like having the chills and then feeling flush), and shooting pains (almost like an electric shock). The fact that these lists of both mental and physical symptoms of anxiety are so lengthy is the main reason that people often confuse anxiety with other ailments, such as a heart attack or a traditional stomach ache. These are all the body’s response to anxiety provoking stimuli.

Now, the lists are quite long, but it is actually normal for a lot of people to have these episodes as a part of the more “traditional every day anxieties” (job interview, nervousness before potentially life-altering events, coming to terms with the vulnerability of life, curiosity about the meaning of life, realistic fears about new situations and events). However, if they become excessive, irrational, and intrusive on one’s ability to go forth with their daily life, there is chance they could be dealing with an anxiety disorder. If you’re curious about how you can determine whether anxiety is a problem in your life or controls your life, you can take a survey called the Overall Anxiety Severity and Impairment Scale. This was developed by the National Institutes of Health to help people create a better understanding of how anxiety may affect them. It asks questions like, “when do you feel anxious?” or “how often do you feel anxious?” and “to what level do you feel anxious?”. This understanding will give you information about where you fall on the anxiety scale, so that you can start finding ways to cope. The good news is that everyone can benefit from some coping mechanisms to help combat every day anxiety or an anxiety disorder.

A good first step in coping with anxiety is understanding what triggers it. Is it large crowds of people? Is it deadlines of responsibilities at your job? The disarray of your room or office? Questions about what you should be doing with your life? Whatever they may be, it is important to pinpoint what they are, so that when those types of thoughts manifest in the mind and then show themselves through your bodily action, you can be aware of them, and deal with them in an appropriate way. The next step is to figure out what way or ways you would like to take more control over the affects of your anxiety.

Some of the short-term strategies that can be implemented on a short notice include mood tracking, exercise, meditation, deep breathing, touch, and getting more sunlight. Mood tracking can help with understanding your triggers because you’ll be able to pinpoint the days that you felt anxious or experienced other negative emotions and connect it with the day’s experience. This will help you understand the events that bring out the anxiety within you. This can also help you plan for events that may be anxiety provoking and allow you to be more in tune with the events of each day that bring you anxiety.

Being in an anxious state is also a “disequilibrium” of both the mind and body, which is why you also need to counteract it with habits like exercise, meditation, deep breathing, touch, and getting sunlight. All of the aforementioned activities help to counterbalance the negative stress hormones that are released because these activities help release endorphins, dopamine, serotonin, and oxytocin, which are all crucial in helping maintain positive emotion and well-being. Exercise releases endorphins which block pain receptors and enhance positive emotion, whereas meditation and deep breathing release dopamine, serotonin, oxytocin, and endorphins. This helps to regulate blood pressure and heart rate when it has risen too high and give you an understanding that thoughts are a biochemical response (meaning a chemical response in our brain), but not always a reality.

Some of the longer-term strategies for combating anxiety include creating mantras or phrases to serve as reminders and encouragements to look at when anxiety hits. This will remind you that anxiety can be a temporary state, as long as you are taking the right steps to combat it by engaging in the habits previously stated, and maintaining a perspective to overcome the anxiety. It is also crucial to take the viewpoint of recognizing that people are not defined by their failures. People often get wrapped up in the idea that failing at one thing means that they’ll fail at many other things that they try. This creates a flight or freeze response with a preceding trigger. Another great long term strategy is to try to “learn optimism”.

Yes, we can actually learn optimism because we can train our minds to think differently over the course of time with thoughtfulness and consistency to practice. There is a model out there called the ABCDE model that was created by psychologist Dr. Martin Seligman. ABCDE standing for adversity (the challenge or anxiety we’re facing or have faced), beliefs (our thoughts/beliefs about the adversity we’re facing or have faced), consequences (how we feel/felt or behave/behaved), disputation (arguing against/disputing our beliefs), energization (outcome or effects of reframing the thoughts). It definitely will take awhile to get a hold on practicing this each day because of the extensive process, but it is a journey that is well worth one’s while if they’re looking to make some positive changes about their anxiety. It is important to also be disputing negativity within oneself using legitimate evidence, legitimate alternatives, implications for the alternatives, and identifying the usefulness of the alternatives.

Anxiety can take many shapes and forms which is why it can be so confusing to cope with. However, creating an understanding of what anxiety is, can help us identify when it’s happening, and how we can cope with it. It is important to realize it can take the form of both mental and physical symptoms, such as excessive worry about the future or present, obsessive thoughts or behaviors, chest pain, shortness of breath, and increased heart rate, to name several. Once we’ve identified how we are being affected by anxiety, we can think of how it is that we can cope with it. It is best to start small with manageable tasks like getting more exercise, doing some deep breathing, getting out in the sun, and tracking our moods. From there, we can try to build larger mental frameworks by implementing some more positive psychology in our daily lives by creating mantras or positive notes of encouragement that we can refer to when times start to get challenging. We can also try to adopt Dr. Seligman’s ABCDE model to reframe how we think about our anxiety provoking events. The most important part is to take all of this, one day at a time.

Sources

“This is Your Brain on Anxiety” by Faith G. Harper PhD
The Anxiety and Depression Association of America
Adrenaline, Cortisol, Norepinephrine: The Three Major Stress Hormones, Explained by Sarah Klein of the Huffington Post
“Learned Helplessness and the ABCDE Model” from habitsforwellbeing.com

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