Getting anxious or nervous is a normal protective reflex in situations where we feel uncomfortable or frightened. It is an automated warning from our brain that we are changing our behaviour or doing something new, or something which possibly has some risks attached to it. Adrenalin starts to flow, which actually makes our muscles and our brain work better. Therefore, a reasonable amount of anxiety is beneficial in difficult situations, such as doing an exam or having a job interview. After the stressful period has passed, it is normal to feel drained and tired.
Excessive anxiety is a different level, and involves a sense of apprehension or a fear that something bad is about to happen, or involves a person feeling very “stressed”, feeling uptight, and feeling very tense. In particular, many people find themselves worrying continuously about the issue at hand, or indeed about multiple issues, going over and over the same thoughts in their mind.
In association with excessive anxiety, people have a range of other psychological reactions, such as being irritable, having trouble concentrating and remembering, being intolerant of noise, and having trouble sleeping. Some people will jump when there is a sudden noise. Many people who are highly anxious feel tired all the time.
Physical symptoms are very common when people are anxious, such as a feeling of discomfort in the stomach, tension and pain in the muscles around the back of the neck and shoulders, tension and pain in the jaw, and a racing heart. Many headaches are caused by tension (which is why ordinary painkillers may not work, unless they contain a sedative as well as a painkiller, such as Mersyndol). Indeed, anxiety can cause almost every physical symptom known to medicine, ranging from shaking of the hands to dizziness to severe chest pain similar to a heart attack. In particular, anything in the body that is painful is likely to be much more painful as anxiety increases.
Panic reactions are the extreme manifestation of anxiety, with people feeling terrified, or feeling they are about to die to go crazy. In severe anxiety, people become progressively less able to function.
Phobias occur when someone becomes not just generally anxious, but particularly anxious with regard to certain situations (e.g. leaving the house alone = agoraphobia) or objects (e.g. a fear of getting into a lift). Depression is a complication in those who are very anxious, and indeed it is often difficult to decide if a patient has depression with associated anxiety, or anxiety with associated depression.
Obsessive Compulsive Disorder (where people have recurring thoughts or patterns of behaviour they know to be silly, but almost irresistible) occur when the patient gets too frightened by the anxiety to resist the “silly” thoughts or actions involved.
TIPS ON RESISTING ANXIETY AND WORRYING:
- Relaxation techniques.
For mild and sometimes moderately severe anxiety, learning various relaxation techniques counteracts the symptoms of anxiety. This may involve learning simple muscle relaxation exercises, learning Yoga, learning meditation, learning Tai Chi or learning self-hypnosis. These are useful skills, and you may need to find one that suits you. Also, they do need to be practised reasonably often, so that you can in effect, re-programme your brain to take this alternative approach to life. When anxiety is severe, you may find you cannot concentrate enough on the relaxation techniques to gain benefit. However, if medication can reduce your symptoms to be mild or moderate in severity, relaxation techniques may then be useful, and will allow earlier withdrawal of the medication.
- “Relax 100 times a day”.
This involves 10 seconds of taking one or two deep breaths, and consciously relaxing your whole body, as often as you can during the day, such as every five or ten minutes. This again is attempting to re-programme your brain into a calmer approach.
- Stopping worrying.
This is easier said that done of course. Unfortunately, worrying repeatedly over the same issue makes your brain think something constructive is being done. Of course, nothing constructive is achieved by worrying, and it becomes a time-consuming and distressing situation. The core issue is that we cannot control the future; worrying more and more about what may or may not happen, actually has no influence on the future. We all have to learn to wait and see what is going to happen, and deal with it when it does happen. Rather than endlessly going over the same “what if” scenarios, it may be useful to write down what issues are relevant to a particular problem you are worrying about. If you then find yourself going over the same problem at a later date, check that there is nothing you have left out of your written material and accept that you will inevitably come to the same conclusion as you came to the first time you wrote it all down, just like coming to the same conclusion in a mathematical formula using the same numbers.
- Schedule a time to worry!
Research indicates that people do indeed get short-term relief from worrying, and many people find it impossible to stop worrying. What can be useful is allocating a certain time period in your day to do this worrying ! When the thoughts intrude at other times of the day, try to tell yourself that you will indeed allow them to intrude, but only at the allocated time. Once you have spent 10 or 20 minutes worrying, you can then allocate a time to worry again the next day if this is what you want to do. Phrased like this, it helps the logical part of your mind to see the pointlessness of worrying, while allowing your emotions some outlet.
- See the anxiety as alien to you.
If you understand that the physical manifestations of anxiety, together with the mental manifestations of anxiety, are in effect inappropriate bursts of adrenalin, which have nothing to do with your real life, you are well on the way to separating normal logical you from the emotional over-reaction that is going on. Yes, this over-reaction is happening inside your brain and your chemistry, but try to tell yourself that it has nothing to do with the real you, who simply wants to get on with life and whatever you are doing. Trying to see the anxiety as an alien being to be ignored, allows you to see it as a separate object, which you are determined to ignore as much as possible. Accordingly, when you get symptoms of anxiety you can see them as simply symptoms which have got nothing to do with the real you, and these symptoms cannot harm you.
- Any attention makes anxiety worse.
Your brain tries to decide what is important, based on how much attention you give various things in your life. If you give the anxiety symptoms a lot of attention, they become more frequent and stronger. Conversely, if you ignore the symptoms as mentioned, and dismiss them as a glitch in your biochemistry, and refuse to think about them, your brain slowly gets the message.
- Tell yourself what you would tell a friend.
This is one of the fundamental principles in CBT (Cognitive Behaviour Therapy). We are all very good at giving sensible advice to other people who are distressed, so try to think what logical cross-questioning and persuasion would you apply to a friend who had anxiety symptoms. For example, someone who was very afraid they might have a serious illness because of a few minor symptoms, would be told by friends that this was theoretically vaguely possible, but extremely unlikely. Similarly, someone who is afraid to go out of the house alone, or get into a lift, would understand that they would not apply the same advice to their family and friends, so the dangers the patient anticipates must really not be that likely. A core phrase in overcoming anxiety about bad things that might happen is “play the odds” accepting that bad things do happen from time-to-time, but in reality they are statistically rare events. Many people worry about bad things that might happen, when the statistical reality is that they are just as likely to win Tattslotto!
- Make your brain focus on something else.
In theory, the human brain can only focus on one issue at a time, so focussing on the practicalities and realities of life will prevent the brain from getting carried away with intense anxiety and worry. If anxiety and worrying continue to intrude into your mind, you can try mental problem solving, such as doing mathematics in your head, or spelling words backwards.
- Thought stopping.
This technique comes in two forms. The first technique is to shout “Stop” (either out loud or in your own mind) at the recurring intrusive anxiety thoughts. The second technique involves wearing a rubber band on your wrist, and springing the rubber band back against your wrist, as pain has priority in the human mind, and may break the intrusive cycle of thoughts.
- Do not seek reassurance from others !
If you become reliant on other people for help in overcoming irrational thoughts and irrational worrying, you will always need to have somebody in this role for you. Apart from this being impractical, it is very likely to strain relationships with other people, if you are frequently asking for reassurance about the multiple possible anxious scenarios that your brain can dream up. It is far better to see your anxiety and worrying as a bad habit your brain has developed, with or without associated chemical changes in your brain, and tackle those symptoms along the lines described in this paper.
As mentioned earlier, it is possible that anxiety is a symptom of depression, in which case, treatment of the depression will automatically reduce the anxiety. In some cases, intense anxiety is due to physical problems, such as an overactive thyroid gland (often associated with heat sensitivity and weight loss). People who are prone to anxiety may benefit from avoiding caffeine, such as in coffee or cola drinks.