“Don’t Worry~Be Happy”
The Age of Anxiety
Martha M. Tate, LCSW
If you read the first line of this title and felt like throwing a tomato at me, chances are you may be struggling along with 40 million Americans with some form of anxiety. Anxiety is a complex issue, parading itself in many lives along a continuum from simple to severe. “In normal amounts, anxiety is healthy, adaptive, crucial for survival and often leads to greater productivity and enhanced performance. When daily anxiety is excessively high, however it can interfere with functioning.” Elke-Auercher-White, PhD.
The good news is, there is help. The better news is, the recommended methods of healing are salubrious to anyone, anxiety sufferer or not, who wants to create health and harmony in a busy life. Solutions are not as simple as “Don’t Worry~Be Happy”. They are far more engaging and rewarding!
What is Anxiety?
From Latin augere: to choke or throttle
“The only awful sound she heard in her ears was the pounding of her own racing heart and the wheezing of her shallow breath. Her sweating palms and tremulous voice were more difficult to disguise than were the fearful voices running amuck in her head reminding her of the imminent dangers and necessary remedies. Those she could cloak. She had done it for years. What she hated most were the sudden sensations of unreality, like she was watching life and neither in it, nor in her own body. These moments intruded fleetingly, out of the blue. Who knew when they would come? That was the worst part.”
If this passage describes the experience of one facing a Bengal tiger, the symptoms would serve physical survival. It describes, instead, a woman suffering with fear, anxiety, and panic. Nature, with her eye on preservation of the species, brilliantly equips us with this panic reaction in the face of life-threatening danger. In modern life, where Bengal tigers are few, we continue to experience this fight or flight response. We do so now as we face the stresses of modern life: a lingering pandemic, political and financial upheaval, and existential uncertainty. The physiological wiring for protection is denied its physical release in modern society. Instead, it doubles back on itself, leaving us with the uncomfortable symptoms of anxiety.
Fear and anxiety are kissing cousins. “Fear is the emotional response to real or perceived imminent threat, whereas anxiety is anticipation of future threat.” DSM-5 (The Diagnostic and Statistical Manual of Mental Health Disorders)
We define them as negative or positive depending on whether they help us or hurt us. Fear helps us to recognize danger and impels us to protect ourselves. Anxiety motivates us to work hard, concentrate attention on the task at hand, and to problem solve. Anxiety becomes problematic when it is excessive and thwarts our ability to think and perform life’s duties. Also, when it occurs “out of the bule” in response to no logical or obvious trigger it is foe, not friend. Its evolutionary roots, however, are friendly.
Physiology of Fear/Anxiety
It can be helpful to understand what is going on in our bodies when fear and anxiety are rampant. What we understand, we can master and harness for our own good. The physiology of fear and stress goes like this.
Something troublesome happens in our world sphere that captures our attention, either consciously or unconsciously. The brain then kicks into action as a tiny almond shaped organ called the amygdala, known as the fear center of our brains, activates another small organ called the hypothalamus. In the relay system of stress, the hypothalamus sends a signal to the autonomic nervous system, which regulates respiration, circulation, digestion, and body temperature. The autonomic nervous system (ANS) is comprised of the sympathetic (SNS) and parasympathetic nervous system (PNS). The SNS excites the body and prepares it for the flight/fight response. The PNS relaxes bodily functions and creates the relaxation response. These two arms of the ANS operate in relative dominance like a see-saw. When one is up, the other is down.
When fear stimulates the SNS, the ensuing reaction is a very rapid cascade of nervous-system firings and release of stress hormones adrenaline, noradrenaline and cortisol. This causes an increase in heat rate and a redistribution of blood to the large muscles and a decreased flow to skin hands and feet, GI tract and kidneys. Increased blood flows to extremities causes numbness or tingling. The lungs respond by breathing heavier and faster, supplying extra oxygen to the muscle tissues. Sweating cools the body and prevents it from over-heating. The adrenaline secreted increases concentration and alertness. The incredible correlation of neuro-endocrine systems creates the necessary state of arousal. Before adrenaline, noradrenaline, and cortisol reach harmful levels, other chemicals destroy them and the PNS activates in order to restore balance to the mind-body.
This is the mechanism of the famous fight/flight or stress response. Our fortunate ancestors, faced with Bengal tigers and physical survival, got to see the process through to the end.
We, facing a pandemic, lockdowns, and health concerns for ourselves and loved ones, are not so fortunate. Our threats are of a different nature. And, the natural ways we soothe and restore; person to person visits, hugs, in person church services, school and work communities, are temporarily off limits. We can get stuck in the muck and mire of undischarged stress response.
Call it anxiety.
Anxiety vs. Fear
In truth, our aforementioned primitive ancestors were dealing with fear, which we now differentiate from its more complex cousin, anxiety.
“Anxiety is related to fear, but is distinct. Whereas fear is concrete and imminent, anxiety is, as neuroscientist Grillon says, ‘sustained uncertainty. It is a chronic sense of uneasiness about a vague future, a gnawing worry about what may or may not happen.’” Andrea Petersen
“Fear is about something that is in front of you that is predictable and imminent. Anxiety is the opposite. It is worrying about something that is in the future that may not happen.”
Dr. Joseph LeDoux beautifully clarifies this process,
“Anxiety happens when thoughts interact with this threat-defense mechanism. While our body goes into flight or fight mode, our mind conjures catastrophe and dredges up memories of peril. The result is the conscious experience of anxiety.”
When is Anxiety a Problem?
Mae West said, “Too much of a good thing is great!” Not so with anxiety. Just enough anxiety focuses our attention, highlights important problems, and motivates us towards action. Excessive anxiety is paralyzing and creates havoc in mind-body-spirit.
Anxiety disorders are the most prevalent of mental health disorders. And, they come in differing varieties. The DSM-5 defines and describes 11 different anxiety disorders stating, “The anxiety disorders differ from one another in the types of objects or situations that induce fear, anxiety, or avoidance behavior and the associated cognitive ideation (thoughts).”
Central to all, though, is the experience of fear, worry, and dread.
“It is as if the anxious brain were always scanning the horizon for danger.” Andrea Petersen
One in three Americans over the age of 13 will experience an anxiety disorder. 40% of women will. In 2016 the American College of Health Association reported that 17% of college students will be diagnosed or seek treatment for anxiety in a given year. Covid-19 concerns increased the suffering. A recent study at a large university found that 71% of the student study reported significant increases in stress and anxiety due to covid-19. Anxiety, already the most prevalent of mental health challenges, is exacerbated by the pandemic and can be a gateway diagnosis to depression, substance abuse, and suicide.
It is also very amenable to treatment and good outcome!
Generalized anxiety, separation anxiety, specific phobia, social anxiety, panic disorder, agoraphobia all fall under the umbrella of anxiety disorders. Each of these problems will be highlighted separately in ensuing articles.
Basically, when the fear and anticipation of harm in ordinary life becomes out of proportion, longer lasting, and interferes with comfort in daily life, anxiety has become a problem.
Taming The Tiger
Imagine this. Your anxiety is like a heard of two-year-olds running rampant through your body without discipline, hyped up on sugar and undirected energy. Your job is to manage them with lovingkindness, firmness, and structure. The goal is to harness and direct the energy so that they can be the delightful, energetic, well behaved children that they are capable of being. To do so you will need to reestablish nap times (so that their PNS can reestablish the balance of rest); provide prescribed times for work, play, and rest; respond to their emotional and nutritional needs; and teach them how to get along with each other.
Maybe all we do need to know we did learn in kindergarten!
Whether you need to get control of excessive anxiety or simply need to manage life a little better, REAP is a good guideline.
Recognize and accept your feelings. Know the symptoms of anxiety so that when they occur, you can identify them early. You may have all or a few. They are:
Rapid heart rate; shortness of breath; feeling of unreality; sweaty palms; voice shaking; fatigue; restlessness; dizziness; burst of adrenaline; insomnia; difficulty concentrating or mind going blank; irritability; muscle tension; sleep disturbance; excessive worry; avoidance of situations that frighten you.
Evaluate anxiety and the thoughts contributing to it. Think about your feelings. Are they proportionate to the events? Would others agree? How strong is your anxiety? Is there anything you can do about the distressing events?
Act. Do something. Learn relaxation techniques such as breath work. Contemplative Prayer. Meditation. Yoga. Progressive muscle relaxation. Exercise. Play. Face something you’ve been avoiding. Decrease caffeine, refined sugars, and additives that cause flashes of anxiety. Learn assertiveness skills, taking charge and saying, “no”. Seek help from a mental heath professional, physician, or clergy who can suggest a helping professional.
Prevent anxiety by assuming some lifestyle changes that increase long term peace of mind. Build social supports that are open and honest. Take the time to enjoy them. Maintain a regular program of aerobic exercise and relaxation/meditation practices. Do stress inoculation by mentally rehearsing positive outcomes to troublesome situations. Seek the mental health care and support that you need to help you on your journey through anxiety.
Anxiety is triggered by a perceived inability to cope with a situation and the body’s chemical response to this belief. By increasing your psychological heartiness, your spiritual connection, and your ability to calm your body, you greatly increase your ability to enjoy peace of mind.
What else can you do?
Funny you should ask.
Humor is scientifically proven to reduce stress. Dr. William Fry of Stanford University states that humor decreased physical stress and is antithetical to rage and hostility.
Norman Cousins, when diagnosed with connective tissue disease and ankylosing spondylitis, researched the biochemistry of human emotions, which he long believed were the key to human beings’ success in fighting illness. With a 1 in 500 chance of recovery, Cousins developed his own treatment protocol which included self-induced bouts of laughter by watching the TV show Candid Camera and other comic films. Cousin says, “I made the joyous discovery that ten minutes of genuine belly laughter had an anesthetic effect and would give me at least two hours of pain-free sleep”. The neuropeptide beta-endorphin released in laughter is nature’s morphine for reducing pain and tension.
Laughter and play exercise the lungs, stimulate circulatory system and increase oxygen in the blood. Dr. Lee Berk reports that laughter aids the immune system by reducing cortisol (stress hormone). It shifts perspective and decreases blame, judgement, and self-pity.
So…take your funniest friend to lunch!
When to Consider Medication
Numerous studies show that behavioral therapies such as counseling and psychotherapy are effective at creating long term changes in our brains and thereby emotional patterns. Medications also have their place in the treatment of anxiety. The use of psychotropic medications is a wise choice for many in their self-care regimes. Some anxiety sufferers require long term, perhaps lifetime, use of medication to quell their anxiety. Others may use it until different types of therapy have altered their pattern of anxiety sufficiently and peace of mind is possible without medication. Either way, there is no shame in giving our brains the nutrients needed to support our well-being.
We are fortunate to live in a time when many forms of healing help are available.
Wounds as Windows
“Anxiety is a doorway into a self that longs for wholeness.” Sheryl Paul
Each of us has a wound of some sort. A place of hurt that seems to interfere with our well-being. Many of us have come to realize that these very wounds can be windows into our souls. That we can experience God in these broken places where deep healing can begin. We then become wounded healers, able to offer ourselves as invitation to others who desire to embark on the hero’s journey of healing.
“For anxiety is both the wound and the messenger, and at the core of the message is an invitation to wake up.”
When we look, we can see that;
“Anxiety is evidence of our sensitive heart, our imaginative mind, and our soul’s desire to grow toward wholeness. It is an invitation from the wellsprings of being to turn inward and heal at the next layer of growth.” Sheryl Paul
Your life, dear reader, is your journey. May you travel it well, finding the health and wholeness you seek. And then, from the bounty of your expanded soul, pay it forward to your fellow sojourners.
So, here’s to your health and happiness. And…to your journey towards that enviable peace that sings:
“Don’t worry. Be happy.”
The Wisdom of Anxiety by Sheryl Paul
On Edge: A Journey Through Anxiety by Andrea Petersen