At its core, anxiety is a natural response to a perceived threat, but the feeling of anxiety can range from mild discomfort to severe distress. How intensely we feel anxiety depends on the threat level we assign. In the case of public speaking, for example, some people assign a higher threat level to it because they fear embarrassment or humiliation. Other people might assign a lower threat level to it because they feel confident or aren’t as bothered to save face.
Managing anxiety thus becomes an exercise in understanding ourselves better and how we relate to certain situations; learning how to manage our anxiety response; and reframing the perceived threat. This article presents our understanding of anxiety and how we approach its management in individual therapy.
Content:
· What is anxiety and where does it come from?
· Modern anxiety and what it has become
· Managing anxiety
What is Anxiety and Where Does it Come From?
Anxiety is a natural response to a perceived threat that we experience physically and psychologically. From an evolutionary perspective, the anxiety response serves a crucial survival function. It is part of the body’s natural “fight or flight” response, designed to improve our chances of survival when faced with threats or dangers in the environment – such as the tiger.
To help us improve our chances of survival from such threats, our bodies have evolved to respond with several physiological changes the moment our brains perceive a threat:
Adrenaline and cortisol are released to enhance physical and mental performance. These hormones increase alertness, sharpen senses, and make allowances for bursts of energy. This helps you be more reactive, think quickly, and have more stamina in situations where speed and decision-making are critical for survival.
Breathing and heart rate increase to improve oxygen intake and distribution. This enhances the circulation of oxygen-rich blood to vital organs and muscle groups to prepare for and sustain rapid bursts of physical effort in response to threats, allowing you to either run from danger or fight more effectively.
Blood flow is directed away from non-essential systems such as digestion, reproduction, and the immune system, and redirected toward essential areas like the muscles, the heart, and the brain. The prioritisation of these areas optimises your ability to fight or flee.
Pupil dilation occurs to allow more light to enter the eyes. This enhances your vision to help you detect and assess threats more quickly, especially in low-light conditions, improving situational awareness and reaction time.
Hearing sharpens to heighten your sensitivity to sounds. Better auditory perception allows for early detection of approaching threats or signals from the environment, increasing the chances of recognizing danger from further away.
Glucose and fat are released to supply quick energy to muscles. A rapid boost in available energy allows the body to sustain intense physical activity, like running away from a predator or engaging in a physical confrontation.
Muscle tension occurs to prepare you for quick, powerful movements, essential for either fighting or fleeing.
Essentially, the body changes to a state of hypervigilance and preparedness for quick bursts of physical exertion – a highly stressful state. In the past, once we have escaped from or neutralised the threat, our body can revert to a state of relaxation so that we can continue with our regular programming. In the modern world, however, it isn’t that straightforward. Although we are no longer running from tigers or fighting bears in the city, we have other threats to our well-being.
Modern Anxiety and What It Has Become – The Paper Tiger
We have come to define modern anxiety as the activation of the fight or flight response to a perceived threat – the paper tiger. A perceived threat is an interpretation or belief that something poses a danger or risk, regardless of whether the threat is real or objectively harmful. In other words, it refers to a subjective interpretation of a situation as potentially harmful to physical, emotional, or psychological well-being. For example, someone might experience social anxiety if they perceive a high likelihood of being judged or rejected by others in social settings. Another person may experience health anxiety when they misinterpret normal bodily sensations, like a headache or dizziness, as signs of a serious illness.
Instinctively, a person experiencing anxiety is being driven towards a fight or flight response to escape from or neutralise the threat. The socially anxious person may be driven to avoid social interactions while the hypochondriac will be driven to make an appointment with the doctor to beat the illness. Each of these actions provides the person with some form of relief from their anxiety – a reward for their behaviour. Social withdrawal provides relief from the threat of exposure while a negative diagnosis confirms that we are not ill. This, in turn, is the recipe for repetition – leading to an expanding conceptualisation of a dangerous world and increasing entrenchment in their dysfunctional responses to the anxiety.
Then we have chronic anxiety. This occurs when we cannot escape or neutralise our perceived threat. Ongoing workplace stress, chronic health conditions, toxic and abusive relationships, and financial instability are all examples of modern-day threats that are difficult to escape or neutralise quickly. In this prolonged stress state, the physiological changes that were meant to aid in our survival become highly damaging:
Persistent high levels of adrenaline and cortisol can lead to a compromised immune system, weight gain, and impaired decision-making.
Rapid and shallow breathing leads to hyperventilation which can cause dizziness, shortness of breath, and tingling sensations. This can result in feelings of panic and worsening anxiety, creating a cycle of distress. Prolonged elevated heart rate and blood pressure can strain the cardiovascular system, leading to chronic conditions like hypertension and increasing the risk of heart disease.
While increased blood flow supports alertness, it can also lead to overactivity in the brain, causing difficulty concentrating, racing thoughts, and impaired decision-making.
Sustained pupil dilation can cause light sensitivity and difficulty focusing, leading to visual discomfort and headaches.
Prolonged heightened sensitivity to sounds can lead to auditory overload and stress. This can also make it harder to concentrate during a conversation when sounds like creaks or bumps become more pronounced.
Prolonged stress can result in metabolic issues such as insulin resistance, hyperglycaemia (high blood sugar), fat deposits in unwanted areas, muscle breakdown, overeating, chronic inflammation, and fatigue.
Ongoing muscle tension from anxiety can result in muscle pain and stiffness, tension headaches, Temporomandibular Joint (TMJ) Disorders, reduced mobility and flexibility, and postural problems.
Suppressing digestion, reproduction, and the immune system can lead to bigger problems. Digestive system suppression can lead to gastrointestinal disorders, malnutrition, and extreme weight changes. Reproductive system suppression leads to dips in testosterone levels for men and irregular menstrual cycles for women which impact sex drive and fertility. Immune system suppression increases the risk of infections and inflammation, and delays healing.
Managing Modern Anxiety
Managing modern anxiety involves identifying the perceived threat and what it is a danger to, managing our anxiety response, and developing strategies to better manage the threat. The goal here is to reduce the threat level to one that is more manageable. Working with a mental health professional in therapy can be particularly helpful in helping people conceptualise the perceived threat and discover why they are responding so intensely to it. Therapists employ effective modalities such as Cognitive Behaviour Therapy to help conceptualise your situation and de-catastrophising, and Person-Centred Therapy to help draw out personalised coping skills based on your strengths.
These sessions involve helping individuals understand, challenge, and change unhelpful thought patterns and behaviours surrounding their fears and worries. It also helps in appreciating everyone's unique struggle with their anxiety and building confidence in the ability to determine the relationship with it moving forward.
In essence, anxiety management focuses on empowering individuals to gain control over their thoughts, emotions, and reactions to anxiety triggers.
If you are struggling with anxiety, please feel free to reach out to us. We would be happy to support your journey in any way that we can.
We offer a 15-minute free online consultation for a risk free opportunity to ask us about any questions or concerns that you may have. This can also help you figure out if you are comfortable to continue working with our therapist in your very own individual therapy sessions.
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