Day 8: Anxiety – What It Is and Why It’s Not Just Too Much Worry

When you think of “anxiety”, what comes to mind? Feeling nervous? Worrying? Wanting to hide under the blankets and never come out? Anxiety can be all of those things – or none of those things. It’s a term commonly used to describe being stressed out, feeling fear, nervousness or worry. In fact, anxiety is a very specific type of reaction to stressors that many include worry or panic or even physical ailments.

Let’s define what we mean when we talk about stress and anxiety, worry and panic.

Stress, in simplest terms, is a physiological reaction to some external stimulus or event referred to as a stressor. We experience it most often in relation to something like trying to meet a work deadline or rushing to an appointment. It’s that physiological push of adrenaline and other neurochemicals that give us that feeling of a racing heart, sweaty palms, or quickened breath. These sensations are sometimes incorrectly referred to as “having anxiety”. Some stress is good in that it keeps us motivated and moving forward. Too much stress though is a problem.

When you encounter something stressful, your body activates your stress response system. This quick fight-or-flight reaction is what kept our ancestors safe from predators and other dangers. Today, that same reaction serves the same purpose.

Acute stress is immediate and once the threat has passed, the body returns to a state of calm. Chronic stress occurs when the stressor does not pass (like ongoing conflicts with someone, a high demand job). The body remains in a constant “fight or flight” mode. This results in a number of physical and emotional effects such as chronic fatigue, physical ailments, and mood disruption.

Worry is often mistaken for anxiety too. It is one component of anxiety. Worry is a cognitive process meaning it happens “in your head.” Worry occurs when your mind dwells on negative thoughts, ponders the “what if’s” and focuses on all the things that “could” go wrong. These thoughts tend to be repetitive and obsessive. You can’t stop thinking about them. Worry is not anxiety but is the cognitive part of anxiety.

Panic is a sudden and intense feeling of fear, terror or discomfort that seems to come out of nowhere often with no obvious trigger. Panic is characterized by several physical and mental symptoms including fear of losing touch with reality, fear of dying or feeling detached, racing

heart, chest pains, dizziness, trembling, shortness of breath and more. These attacks peak within about 10 minutes and then subside. Panic can sometimes be associated with heightened anxiety but not always.

Anxiety is a complex neurochemical, physical and psychological reaction to some stressor or perceived danger. It is experienced in your mind and in your body. Anxiety tends to intensify over time and is highly correlated with high stress and excessive worry about some potential real or perceived threat.

Symptoms of anxiety are similar to those of panic but tend to be less intense and more persistent. Anxiety symptoms can include poor concentration, irritability, disrupted sleep, muscle tension, and dizziness. Left untreated, chronic anxiety can become overwhelming and affect your daily functioning. It can be exhausting.

Anxiety can take many forms and affect you in different ways. You’ve probably heard about generalized anxiety (the worry about “what ifs”). Other common anxiety disorders include agoraphobia, social anxiety disorder, and panic disorder. Anxiety can even sometimes be related to a person’s medical condition.

How you experience it might be very different than someone else. Not everyone’s anxiety rises to the level of a diagnosable disorder. Even then, symptoms can be no less disruptive. The important thing is to know there are things you can do to manage your anxiety.

First, let’s talk about that causes anxiety.

There is a lot we don’t know about anxiety. Why do some people suffer from severe anxiety while others seemingly let high-stress events just roll off their backs? Why do menopausal women seem to be particularly susceptible to anxiety? Science is still uncovering new data about anxiety all the time.

What we do know about anxiety is that it generally develops over time and often in response to some event such as a trauma, an illness, or excessive stress. Certain personality types have been found to be more susceptible to anxiety disorders. Having a blood relative with an anxiety disorder can predispose you to have one as well.

Anxiety affects women almost twice as often as men. While it can affect a woman at any age, perimenopausal and menopausal women often experience intense anxiety, even if they have no history of problems with anxiety. Just why that is so is still not fully understood but it is a real phenomenon. It is not all in your head. And just blaming it all on hormones doesn’t seem to fit either. We will be exploring menopausal anxiety in an upcoming session but for now, know that, if you are menopausal and experiencing anxiety, you are not alone and what you are feeling is real.

Feeling nervous or anxious is normal and something we all experience from time to time. So how does someone go from a little anxious to the kind of anxiety that makes just getting through the day so hard sometimes?

It is thought that anxiety persists over time because of the constant activation of the fight or flight” response. Deep structures in your brain responsible for emotional processing become over-activated.

When you experience a situation your brain perceives as a threat, your brain circuitry is activated. There’s a part of your brain called the cerebral cortex and one of its jobs is decision making. There’s another part of your brain, the amygdala, which is part of emotional functioning. When your “fight or flight” response gets triggered, lightning-fast messages are sent out via powerful neurochemicals to run or fight. And you react. This whole response happens so fast, the cerebral cortex hasn’t even processed what’s happening yet. So you respond before your decision-making part of the brain can even decide if the threat is real.

While this system works great for avoiding danger, it is also susceptible to getting hyperactivated.

Another part of the amygdala’s job is storing emotional memories. In some people, the amygdala becomes so sensitized to certain trigger thoughts or situations that it overreacts, sending the body into “fight or flight” whether the threat is real or not. Over time, that response becomes attached to certain thoughts, memories, or situations that may be totally unrelated to the original threat. Now you’re on guard all the time.

This feedback loop plays out over and over and looks something like this: There is a trigger or environmental cue. It might be a certain sound or a crowded party.

Next, you have a cognitive reaction to the trigger such as a negative thought or negative self talk.

Then comes the physical response, the feeling that you recognize as anxiety. You might experience the physical response as your heart pounding, rapid breathing, dizziness, or other physical sensation. The end result of this feedback loop is what we call anxiety.

This loop reinforces itself over time and teaches the person to avoid the trigger. After all, it’s easier to avoid the trigger and the anxiety response, right? Except that it doesn’t work.

Avoidance reinforces the idea that you’re helpless to deal with the situation. Avoidance also deprives you of the possibility of having a positive experience and data to challenge those negative thoughts and beliefs.

The way to manage anxiety is to address it. And the gold standard for treating anxiety is Cognitive Behavioral Therapy (CBT). In upcoming sessions, we will be showing you ways to deal with your anxiety so that you can break out of those negative patterns and find your way back to a place of balance and peace.