Before treating any condition, it's good to know what you're treating!
When people talk about anxiety, it is rarely in a positive tone but occasionally they should because anxiety is actually a natural and protective defensive mechanism. The primary objective of it is to keep us safe and out of harm's way. The problem though is that in today's modern world, there is actually a lot of either fake or false stimuli that allow us to experience unnecessary anxiety. This is anomalous for a few reasons. Firstly, anxiety itself is mostly about the anticipation of danger, not the presence of it. Secondly, because the brain is unable to differentiate between real or imagined danger, it makes it even more difficult to determine the difference between fake and false sensory stimuli.
This may sound confusing because we are talking about two things that are essentially the same, fake and false, but there is sometimes a subtle difference! While there is not a simple answer to this dilemma, I can hopefully give an example. Fake has all the attributes of being real but is most usually derived from an external source, i.e. someone or something else spreading the fake news. False. On the other hand, equally has all the attributes of truth but is mostly being generated by our brain! A dream of falling is a good example of a real experience of a false stimulus and receiving or reading fake news, e.g. on your mobile or social media, creates real anxiety but is based on fake, non-existent stimuli.
Essentially anxiety is an anticipatory form of fear; i.e. it invokes the fear or stress response (fight or flight)! Therefore, many of the symptoms of anxiety are the same as those of intense fear or chronic stress. In fact, it is very unusual for someone with severe anxiety, not to be exposed to more than their fair share of stressors as well but many of these stressors are not real either. Stress (distress), can be defined as the body, brain and mind's response to real stressors. These stressors can be physical, emotional, psychological and environmental!
I say that Anxiety is an anticipatory form of fear because it is an awareness of what could, would or should happen; rather than what is actually happening. If you walk down a dark street and fear being attacked; anxiety is the response. However, if you walk down the same street and are really attacked; fear is the likely response. But whether it's fear or anxiety, the body's fight or flight response is pretty much the same! Practically speaking, life is far too short to be overly concerned about what might, could or even should happen, even more so when it is obviously unlikely to happen. For example, the fear of flying is perhaps the most illogical of all fears, mostly because it is the safest form of travel; yet the most universally feared! And perhaps the most ironic of statements I have heard in recent years is that of a motorcyclist who wouldn't travel by plane because it is so unsafe!
So, in preparation for a course in Anxiety Management, it makes sense to be aware of its symptoms and you might say "obviously!." But given the number of people I see with anxiety, I know that an awareness of these symptoms is anything but obvious!
Below are some Anxiety symptoms:
Pounding heart (palpitations)
Fuzzy head or giddy feelings
hot or cold flushes
Tingling feelings in hands and feet
Make bad decisions
Make more mistakes or errors
Poor memory or forgetfulness
Becoming insular or withdrawn
Prone to anger outbursts
Feeling negative about life in general
Prone to minor ailments, colds, flu etc.
Exaggerated startle response
Generally feeling unwell or
Having a feeling of foreboding
These are a few of the many and varied symptoms of anxiety. Although anxiety can be defined as an awareness of certain physical feelings, thoughts are almost always involved in the process. The chain of events that lead to anxiety, which is the neural activation of the fear response, is almost identical for all humans. Yet, without a doubt, the way people describe the experience of anxiety can be very different.
The reason thoughts are involved is a consequence of the feelings we experience, which are the result of the type and intensity of stress hormones and neurotransmitters surging through our body. Whilst we are aware of the feeling, we generally have no understanding of the neural processing taking place. To make sense of it we use our thought processes. If we can rationalise what has happened we can often return to normal quite quickly. For example, we hear a loud bang, it sounds like a gunshot, we become fearful, rush to the window and see an old car, the conclusion, it probably backfired!
Because most of our experience of life is outside of awareness (we'd be emotionally overwhelmed if we were consciously aware of everything our brain was processing), we can become anxious seemingly without cause. However, there will always be a reason and anxiety is the consequence of the neural interpretation of any sensory experience, mostly a consequence of memory stimulation. At any point of the day, our senses are processing millions of pieces of information, most of which is relatively neutral, however, as soon as any sensory experience stimulates certain brain regions, for example, the amygdala (a small structure in each brain hemisphere), we have a natural predilection to become emotionally aroused; the greater the arousal, the greater the emotion. However, there is a lot more complexity in the brain's ability to process and rely on the response of just one brain region. There are projections to many regions, to and from the various parts of the amygdala, to mention but two, the nucleus accumbens NAcc and the ventral hippocampus. The NAcc plays more of a role in processing pleasure experiences and the ventral hippocampus plays a role in fear conditioning processes. Research has shown that damage to the ventral hippocampus reduces the amount of information sent to the amygdala by the dorsal and ventral hippocampus, consequently altering the experience and response to conditions that will stimulate a fear response. Essentially these three regions work closely together to process, evaluate and respond to the vast amount of sensory information we have to absorb, every second of every minute of our life!
Throughout our lifetime we have countless such experiences and these invariably involve our thought processes to interpret these experiences, mostly subconsciously, and thus the link between thought and emotion is established. The relationship between thought and emotion varies from person to person and it has been my experience, with very anxious clients, that the level of negativity in their thinking and communication (verbal and non-verbal) has a strong correlation to the development and intensity of their anxiety; thus making it a disorder.
Because the brain cannot effectively tell the difference between a real or an imagined event (think about a bad dream you have had), it is easier to understand the mechanism of anxiety and why I said it is an anticipatory form of fear. Essentially you could define the difference between fear and anxiety as one of time! Fear is the real-time response to what is actually happening and anxiety is what you anticipate will or could happen.
Many of the things we become anxious about were encoded in our brain, specifically the amygdala and its neighbours, as we were developing. When a situation can relate what we feel, with what is happening, the experience becomes contextualised. For example, when your mother was pregnant with you, imagine that she was in an express lift, one that drops very fast, creating that momentary feeling of weightlessness, which then makes her feel frightened. At that moment, your amygdala encodes fear and weightlessness; but no context. Twenty years later, you are on a flight and experience clear air turbulence (where the plane suddenly drops hundreds of metres), followed by weightlessness, then fear, now you have context! The outcome, a fear of flying develops. This can happen even if you are a seasoned flyer and have flown many times before. The computations of a fear type of experience for each of us is almost limitless. However, most people go through life with a normal experience of anxiety, after all, it is a life protecting part of being human; its purpose is to keep us safe.
I define stress as the body's reaction to environmental cues that lead to physiological and psychological stressors. Examples of these stressors can be physical, e.g. excessive heat, cold, noise, crowds or even isolation etc. or psychological, e.g. negative thought or language patterns, emotional difficulty, bad relationships, the death of a loved one, imbalanced brain chemicals etc.
If you have any specific questions, not covered by this article, please feel free to contact me.
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