Coping With Anxiety [general]

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Coping With Anxiety [general]

The mind is in its own place, & in itself can make a heaven of hell, & a hell of heaven [John Milton, Paradise List]

What is anxiety?
– response to the perception of threat
– a sense, a feeling of apprehension & dread that something bad is going to happen
– normally a temporary state
– the feeling may last a few minutes, a few days, several weeks, months or longer

Physical symptoms
– increase in heartbeat
– increase in breathing rate
– muscle tension
– tightness in the chest
– sweating

How does frequent anxiety affect people?
– affects a person’s ability to do things
– ability to enjoy life
– feel safe in the world
– anxiety makes it difficult for people to enjoy their success (or even the moment) or feel optimistic about the future
– impairs our ability to relax
– affects a person’s concentration & ability to focus on what they are doing

Anxiety & fear are often used interchangeably, but they are different
– fear is a reaction to perceived immediate physical danger
– anxiety is a response to perceived future threat

Common threats
– physical safety (waiting for medical results, exam results, walking alone at night)
– material well-being (debt, risk of redundancy, starting up a new business & sustaining it)
– self-esteem (made a big mistake at work; struggle to do things others do easily)
– social safety (when we think someone disapproves of us, going to a function where we do not know anyone)
– psychological well-being (when we start to feel depressed or overwhelmed by anxiety, with the anxiety & depression becoming their own source of threat)

Evolutionary benefits
– anxious ancestors had a survival advantage
– anxiety heightens our ability to detect threats
– anxiety optimises our likelihood of escaping danger
– the fight-or-flight response produces the reserves of energy needed to run away or fight
– the surge in energy enables you to run further & faster than usual

Anxiety today
– today we perceive threats in relation to mostly emotional rather than physical safety:
– deadlines
– demanding customers
– financial pressures
– exam stress
– demands at home & at work
– unpleasant confrontations (the longer you put it off, the longer the anxiety lasts)
– our body still responds as though our life is at stake
– physical changes caused by frequent arousal can lead to problems such as tension headaches, chest pains, an upset stomach, twitches, agitation, exhaustion, panic attacks

Predisposition to anxiety
– some people have high-trait anxiety because the disposition is part of their personality
– these people are likely to perceive neutral or low threat situations as dangerous
– they are also likely to over-estimate the possibility of bad things happening
– predisposition to anxiety is influenced by both genes & childhood experiences (50/50)
– predisposing childhood experiences include:
– parents who were critical
– parents who were punitive
– parents who were unpredictable
– parents who communicated an overly dangerous world view
– exposure to poverty
– exposure to violence
– insecure or unstable home environment
– a predisposition does not condemn us to suffer anxiety for life, we jus need to put more effort into keeping anxiety in check

Different people: different anxiety buttons
– we all experience anxiety differently
– some are anxious about social disapproval, but not physical safety
– some are anxious about physical health but not work performance
– some are anxious about financial security, but not social disapproval

Anxiety disorders
– usually diagnosed when anxiety interferes with our lives & our ability to function
– they can interfere with:
– our ability to hold a job
– catch a plane
– drive a car
– leave the house
– have friends
– enjoy normal relationships
– feel safe in the world
– approx 1 in 7 Australians annually are diagnosed with an anxiety disorder
– people with an anxiety disorder may also suffer with depression &/or insomnia

Effects of anxiety on thoughts, body sensations & behaviours
1) thoughts
– thinking style influences our disposition to anxiety
– anxiety also influences the content of our thoughts
– in the anxious state, our thoughts are more threat-focused (our mind scans for danger)
– a person over-estimates the likelihood of danger
– a person typically “mentally exaggerates” the consequences of that danger

2) body
– anxiety triggers physical arousal
– somatic (physical body) symptoms are triggered by psychological factors, including:
– heart palpitations
– Tremors
– Tightness in the chest
– Sleep disturbance
– Headaches
– nausea
– Dizziness
– fatigue
– Other common sensations include:
– Numbing
– Tingling
– Twitching or electrical sensations
– Appetite change
– Diarrhoea
– vomiting
– Digestive disturbances
– Light-headedness
– Missed heartbeat
– itchy/Crawly skin
– Muscle stiffness
– tightness in throat
– Difficulty swallowing
– Heat surges
– Pain or tightness in the scalp
– Feelings of unreality
– Focusing on our physical sensations may give rise to more anxiety (leading to a “Vicious cycle” of perceived dangerousness producing further anxiety producing further somatic symptoms)

3) Behaviour
– All emotions influence our behaviours
– Anxiety is arguably the most powerful motivator of all
– It can also give rise to behaviours that seriously impact the quality of our lives

4) Motivation and performance
– a moderate Degree of anxiety can sometimes aid performance (Keeping us motivated and focused)
– Severe anxiety impairs motivation & performance
– diminished Concentration & mental blanks
– Errors are more likely
– Reduced productivity and burn-out

5) Avoidance
– When humans perceive things to be unsafe, they try to avoid the perceived aversive experience . For example:
– Social anxiety – Avoid social situations
– Health related anxiety – Put off medical tests
– Anxiety about panic attacks – avoid public places and situations where escape is difficult
– If we’re anxious about the way others perceive us – We are likely to avoid expressing our opinions, communicating assertively or making unpleasant telephone calls
– If we are terrified of failure – We are likely to avoid situations where failure may occur

– Avoidance makes us feel better in the short-term
– However it is counter-productive because it reinforces beliefs that the world is unsafe
– It also does not allow mastery (or a sense of mastery) to develop
– Therefore further reinforcing and maintaining anxiety in the longer-term (while restricting the person’s life)

– Avoidance behaviours may include numbing through:
– Eating
– Alcohol (& other drugs)
– Smoking
– Risk taking
– Gambling

– Such behaviours (often perceived as “remedies”)
– Do you not work in the longer term, &
– often create more problems than they solve (addictive, self-defeating behaviours)

Safety behaviours
– Looking for ways to protect ourselves response to situations of danger or threat
– People with high trait anxiety overestimate the likelihood of danger and consequently frequently do things to protect themselves from harm

Safety behaviours are strategies aimed at minimising the risk of harm:
– They can be mental strategies (e.g. Reviewing a conversation for disapproval signs)
– They can be specific actions (Making repeated medical appointments to rule out the possibility of illness)
– Having someone go with you in order to avoid facing the situation alone
– Making regular phone calls to loved ones to ensure they are safe
– Checking the Internet for possible causes of current symptoms
– Over preparing & mentally-rehearsing things
– Trying to do things perfectly so as to gain approval or avoid criticism
– Setting next to the exit so that you can make a quick escape
– Avoiding situations that are associated with anxiety
– Monitoring and checking things
– Planning solutions to imagined problems

Safety behaviours rarely minimise the risk of harm
– Safety behaviours maintain anxiety because they prevent a person from learning that their fears are unjustified
– When bad things do not eventuate, instead of recognising that bad things rarely happen anyway
– To reduce anxiety we need to identify & relinquish safety behaviours
– This can be done in small steps (Person gets used to the new behaviour without feeling overwhelmed)
– By gradually dropping our safety behaviours – and therefore facing our fears – we discover that our world is safe after all & the person learns that they can cope

Exercise:
a) Keep a diary of the safety behaviours that you use to keep yourself safe (Include the things you avoid)
b) Keep adding to the diary (over time) as you notice other behaviours
c) What are the consequences of these behaviours?
d) Have they really protected you or your loved ones from harm?
e) Write a list of all the downsides of these safety behaviours.

Source: Edelman, S. 2012

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