"Man is not worried by real problems so much as by his imagined anxieties about real problems."
"Every tomorrow has two handles. We can take hold of it with the handle of anxiety or the handle of faith."
-Henry Ward Beecher
What is Anxiety?
You enter a large room crowded with strangers. Everyone seems to know somebody except you. You wonder if others can see how anxious you are, how out of place you feel. As you entertain such thoughts, your heart begins to race, and your palms begin to sweat. Your head feels encased in shrink-wrap. You feel an urge to bolt from the room.
Anxiety is part of our natural defensive system – a close cousin to fear. With fear, however, the threat is more readily identifiable. For instance, someone is waving a gun. A dog is barking, crashing against the cyclone fence.
Like fear, anxiety is the body’s red warning light that something is amiss. The brain releases adrenaline. The pupils dilate. The heart pumps out blood like an engine on steroids, gearing the body to stand up and fight. Or perhaps to run faster than we ever imagined.
A manageable amount of anxiety can actually enhance our performance — by motivating us to prepare for a test, to drive with care, or to gird ourselves for a difficult confrontation. Anxiety also might carry important information. For instance, if I’m anxious at home, it might be helpful to reflect on what’s wrong in order to figure out ways to change it. Perhaps my roommate makes me uncomfortable or maybe I need to have a conversation I’ve been avoiding.
Anxiety becomes problematic when it is disproportionate to the situation or is so paralyzing that we are unable to act. Generalized Anxiety is when anxiety becomes pervasive and free floating, no longer linked in any recognizable way to specific tasks, challenges or threats. Those in the grips of this sort of anxiety often worry about the future thinking of possible scenarios and imagining the worse.
What Causes Anxiety?
Anxiety is a child with many parents. Recent research suggests that there may be a genetic predisposition. At the same time, one might learn the habit of anxiety from caretakers, e.g., a parent who worries a lot and worries excessively about us. Experiences that are physically and/or psychologically traumatic can leave one with a deep-seated belief that the world is unsafe and that bad things are likely to happen. Personality factors can be at work in anxiety as well. If we lack self-confidence and self-esteem, we may not trust our ability to face difficult situations that arise. If perfectionism is at play, we may be hampered by the chronic fear of making mistakes.
Social anxiety may take the form of fearing large groups, speaking up in class, meeting new people, or going out on a date. Some anxiety when interacting with strangers is quite normal. There may be something biological here since, after all, human beings are the most dangerous animals on Earth. Social anxiety becomes problematic when it keeps us from interacting with others or getting close to them. The person who is socially anxious may doubt whether he or she is smart enough, attractive enough, likeable enough, etc. In sum, this individual may feel socially undesirable and inadequate, uncertain how to connect with others in a meaningful way. Fear of bieng judged is a common complaint. Nonetheless, even a socially anxious person may feel comfortable within a narrow circle that includes close friends, roommates, and/or family members. This illustrates that the experience of anxiety is not black or white but rather occupies a continuum.
What about Panic Attacks?
Panic attacks are episodes of extreme anxiety often accompanied by such physical symptoms as shortness of breath, racing heart, sweaty palms, and dizziness. Sometimes a person experiencing a panic attack will think that he or she is having a heart attack or is dying.
Physiologically, panic attacks involve an activation of the sympathetic nervous system or fight-flight response. When we are faced with an extreme danger, this innate response mobilizes us to confront or escape the danger, preparing to perform what seem like “super-human” feats. This fight-flight response is designed to protect us, not to harm us. Panic attacks occur when this hard-wired, physiological response occurs in the absence of an actual threat. Instead of mobilizing us for action, the activation of our nervous system is channeled into anxiety.
One problematic complication of panic attacks is that the individual may learn to avoid situations in which the attack occurred. In more extreme cases, a person might develop a fear of leaving the house. This avoidance pattern can cause a person’s world to shrink down, depriving the person of the experiences that would allow the anxiety to dissipage naturally. Indeed, the fear of having a panic attack can actually precipitate an anxiety attack. Franklin Roosevelt's words to a nation in the depths of the Great Depression may offer wise counsel to a panic attack sufferer: The only thing to fear is fear itself.
The good news is that panic attacks can be addressed by many of the techniques described below. In addition, there are some treatment strategies that pertain specifically to panic attacks.
How can I Reduce & Overcome Anxiety?
Since some anxiety is natural and normal, the goal of any treatment is not to eliminate anxiety completely but to lessen it and reduce its impace. Some strategies are very simple and easily learned. Other avenues are traversed gradually and entail a process of self discovery, with or without a professional guide.
Those who are prone to struggle with anxiety may be particularly vulnerable duing stressful times. Therefore, if you’re anticipating an upsurge (e.g., heading into finals week) it’s advisable to try to lower other sources of stress whenever possible and to attend to basic self-care such as:
- Eating regular, well-balanced meals
- Sleep- Getting enough sleep is key to performing at your best
- Exercise is a great way to burn off stress and let your body wind down
- Avoid caffeine and other stimulants that promote anxiety
Self-Reflection and Facing Your Fears
Perhaps the first step in addressing your anxiety is to ask: where is my anxiety coming from? By engaging in a process of slowing down and reflecting, sometimes we can figure out what’s really bothering us. Then we can strategize ways to resolve it or, through gaining perspective, simply let the anxiety go.
Another way to overcome anxiety is to cultivate feelings and experiences that are incompatible with it. For instance, experiences that build up feelings of self-confidence, well-being, and relaxation offer an antidote to anxiety. Simple exposure to anxiety-provoking situations will eventually extinguish the anxiety response. For example, if you’re anxious among large groups of people, you might seek out more large social situations. Or if public speaking is your bane, take a class that requires frequent class presentations. Nonetheless, sometimes exposure to what makes us anxious can feel overwhelming, and we may need to build up to them gradually.
Stress Reduction and Relaxation Strategies
Since anxiety rises with stress, ways that you can develop to lower and better manage your stress will also have a beneficial effect on your anxiety. Some well established stress-reducing activities include physical exercise, spending time in nature, talking to a friend, listening to or playing music, yoga, and other forms of creative expression. It’s very helpful to end the day with at least 30 minutes of relaxing activity, which allows us to unwind and more easily fall asleep. If the world situation is getting you down, you might consider going on a “media fast.”
Like any skill, Mind-Body techniques for lowering stress and anxiety are more powerful the more often you practice them. This is especially true when you are first learning the technique. If you only make use of a strategy when you are feeling extremely distressed, its effectiveness may be reduced.
Deep Breathing: When we are anxious, our breathing tends to be shallow and fast. In contrast, deep and slow breathing tends to relax us at a physiological level. Begin this practice by lying down or sitting in a comfortable chair. Place your hand on your stomach area. Now, as you slowly breath in, draw the air all the way down into your belly. Feel your hand rise as the breath comes in. You can gently count 1,2,3, 4 as you breathe in. Breathe out to a count of 1,2,3, 4 and hold on the out breath for another 4 seconds. Repeat this practice for 3 – 5 minutes.
Breath Meditation: One simple and effective meditation is to choose a word or two that evoke qualities of experience that you would like to have. For instance, words like courage, trust, peace, well-being, love, equanimity. Choose whatever words seem most appropriate at this time. Let’s say the words you select happen to be openness and trust, now as you slowly breathe in, imagine breathing in openness, opening up your mind and heart, opening to your feelings, opening to goodness, opening to love, etc. Then, as you breathe out, imagine yourself deeply trusting, letting the sense of trust wash through you, bathing your muscles and tendons, your bones and internal organs all the way down to the cellular level.
Body Scanning: Find a quiet room and lie down on a sofa or bed. Take a few deep breaths, letting your attention withdraw from the outer world and to focus in on your body. Now bring your full attention down to your feet. First, allow your toes to relax, then the ball of your feet, then the soul and heel. Very gradually move your mind’s eye up through your body, allowing each part to relax completely, until you reach the top of your head. You can cultivate feelings of relaxation by gently saying to yourself, My feet are relaxing . . . my knees are relaxing, and so on. It’s very important to bring and keep as much of your attention as you can on what your body is actually experiencing. For instance, you may notice sensations of tingling, heaviness or warmth. Whatever sensations arise, just allow them to be as you continue to move up through your body. As you relax your body in this way, your mind also will become relaxed.
A woman we know has a cat who runs and hides every time the veterinarian drives up. Once a year the vet will come out to the ranch to give the cat Whiskers her shots and clean her teeth. If we could only sit down with Whiskers and tell her that the veterinarian means her no harm, perhaps she would calm down and stop acting like a “scaredy cat.” But for Whiskers even the sight of the vet’s Dodge Ram portends an hour of pain and unspeakable terror.
If cats are anything like human beings, we might surmise that what’s most frightening for Whiskers is that she can't control or understand what the vet is doing to her. She can’t say to herself, now she’s cleaning my teeth, now she’s getting ready to give me my distemper shot, which will hurt just a few seconds and then the pain will subside.
Human beings — and perhaps even cats — have inner monologues that shape and color our experience. These monologues have been likened to tapes, or digital recordings, that play automatically, often without our awareness. Some of these running monologues foster anxiety, while others can prevent or allay it. The eminent Roman philosopher Epictetus observed that while we can’t always change external events, we can change how we perceive them. This is the basis of cognitive psychology.
The first step toward changing our self talk is to become aware of it.
One tactic here is to write down everything you say to yourself before and during an anxiety episode. Pay close attention to the parts of your self talk that increases your anxiety or lowers your self-esteem. The next step then would be to counter each anxiety-provoking statement with a more balanced, reassuring thought. For example, if before and during a party you say to yourself (perhaps subliminally), I’m such a geek, no one will want to talk to me, a more balanced thoughts might be: Most people here probably feel a little anxious . . . Not everyone here has to like me for me to have a good time . . . Sometimes I’m not in the mood for a party . . . I’d like to get to know one other person, and if I can do that, I’ll be satisfied.
Affirmations sometimes can be another effective cognitive strategy. The idea here is to replace our negative inner voice with a more affirming one. Affirmations can help immunize us against anxiety by building up our confidence and self-esteem. While the best affirmations are those you devise yourself, examples might be: I am a worthwhile, compassionate person. I radiate love and draw love toward me. I am a student of life, leaning as much from my mistakes as from my successes. While these may sound corny or artificial, are they any less grounded in reality than such statements, I am stupid . . . Everyone thinks I’m worthless . . . ? If we have a choice about our iwhat we say to ourselves, then why not choose a monologue that builds up our self esteem rather than tears it down?
Another cognitive strategy consists of writing out and rehearsing a set of coping statements, for example:
- Don't sweat the small stuff. Things usually work out in the end.
- I trust myself to able to handle whatever arises.
- I will relax my expectations when reality has a different agenda – after all, surprises make life more interesting.
- The future is as interesting and fulfilling as I make it.
- I can’t please everyone. Other people are responsible for their own happiness as I am for mine.
- It's okay to be human. Mistakes are the quickest way to learn things.
Should I take Medication?
Many factors enter into a intelligent decision about whether to take medication for anxiety. Some in our profession believe that society has been moving too far in the direction of viewing psychological problems as primarily biological, prescribing medication as a rote response to any psychological complaint. This is reinforced by the pharmaceutical advertising which can convey that any and all pain or adversity is to be avoided.
If you’re thinking about medication, it’s important to consider both the risks and rewards. One potential benefit includes immediate symptom relief, which may be especially helpful when anxiety becomes crippling. Medication might also be useful to get through temporary situations where it is difficult to perform in school or in everyday life. Another benefit is that some people prefer medication to psychotherapy or mind-body practices.
Some of the risks include drug side effects, treating the symptom rather than getting at the cause, addiction to tranquilizing drugs, and missing out on an opportunity to grow personally by relying on an external substance to change how you feel.
Medication and psychotherapy need not be mutually exclusive, Many UO students make use of both. If you have questions about anxiety medication, you might raise them with your therapist and your physician.
What about “self medication”?
It’s quite common for people to seek unhealthy ways to cope with anxiety. Needing to “get a buzz” in order relax at a party is only one example. Substance, shopping, eating, sexual and other addictions often mask deeper discomforts and distress. Activities that in moderation can be quite pleasurable become problematic when they are compulsive and preclude other ways of finding release and comfort. If you think that you may be “self-medicating” in this way, it would be important to raise this with your counselor.
How can I address the deeper roots of my anxiety?
Anxiety can originate from a variety of emotional sources. Sometimes we experience anxiety or even panic attacks when we are on the verge of a major life transition. Changes and transformations often trigger feelings of loss and related fears, including the loss of identity, loss of support and comfort, and loss of meaning. By talking through such feelings with a supportive confidant, they often diminish in intensity.
A related source of anxiety arises when we are warding off painful experiences from the past. Often we are unaware that we are doing this. By becoming aware of and working through the painful memories that we carry, they tend to lose their energy and capacity to fuel anxiety and other problems.
Much anxiety arises from our relationship with ourselves. If we like ourselves and feel effective in the world and with other people, this helps to immunize us against problematic anxiety. If you are someone who struggles with self-esteem, you shouldn’t despair. The path to self-acceptance and self-love is a journey that has been taken by many before you – a path walked by some of the most admirable women and men in history. But this journey does involve time and effort. Sometimes life itself provides the tools we need to traverse this path. Often, a healing relationship with a therapist or another caring individual can help us unlearn and repair the harm that came to us without our bidding.
Stress Management Resources at the Health Center
Free Guided Meditations at UCLA