Anxiety is something we all experience from time to time. Most people can relate to feeling tense, uncertain and, perhaps, fearful at the thought of sitting an exam, going into hospital, attending an interview or starting a new job. You may worry about feeling uncomfortable, appearing foolish or how successful you will be. In turn, these worries can affect your sleep, appetite and ability to concentrate. If everything goes well, the anxiety will go away.
This type of short-term anxiety can be useful. Feeling nervous before an exam can make you feel more alert, and enhance your performance. However, if the feelings of anxiety overwhelm you, your ability to concentrate and do well may suffer.
Anxiety and fear can protect you from danger. When you feel under threat, anxiety and fear trigger the release of hormones, such as adrenalin. Adrenalin causes your heart to beat faster to carry blood where it's most needed. You breathe faster to provide the extra oxygen required for energy. You sweat to prevent overheating. Your mouth may feel dry, as your digestive system slows down to allow more blood to be sent to your muscles. Your senses become heightened and your brain becomes more alert.
These changes make your body able to take action and protect you in a dangerous situation either by running away or fighting. It is known as the 'fight or flight' reflex. Once the danger has passed, other hormones are released, which may cause you to shake as your muscles start to relax.
This response is useful for protecting you against physical dangers; for example, it can help you run away from wild animals, attackers, fires etc very quickly. The response is not so useful if you want to run away from exams, public speaking, a driving test, or having an injection. This is because, if there is no physical threat, and you have no need to physically run away or fight, the effects of adrenaline subside more slowly, and you may go on feeling agitated for a long time.
If the anxiety stays at a high level for a long time, you may feel that it is difficult to deal with everyday life. The anxiety may become severe; you may feel powerless, out of control, as if you are about to die or go mad. Sometimes, if the feelings of fear overwhelm you, you may experience a panic attack.
A panic attack is an exaggeration of the body’s normal response to fear, stress or excitement. It is the rapid build-up of overwhelming sensations, such as a pounding heartbeat, feeling faint, sweating, nausea, chest pains, breathing discomfort, feelings of losing control, shaky limbs and legs turning to jelly. If you experience this, you may fear that you are going mad, blacking out, or having a heart attack. You may be convinced you are going to die in the course of the attack – making this a terrifying experience.
Panic attacks come on very quickly, symptoms usually peaking within 10 minutes. Most panic attacks last for between 5 and 20 minutes. Some people report attacks lasting for up to an hour, but they are likely to be experiencing one attack after another, or a high level of anxiety after the initial attack. You may have one or two panic attacks and never experience another. Or you may have attacks once a month or several times each week. For some people they seem to come without warning and strike at random.
I’m walking to the village shop, then the earth shifts to one side, my heart’s hammering as if it will explode, my vision is blurred and my hands are sticky with sweat. And I’ve no idea why.
Panic attacks can also come in the night and wake you up. These nighttime attacks occur if your brain is on 'high alert' (due to anxiety) and can detect small changes in your body which it then interprets as a sign of danger. Night-time attacks may be particularly frightening, as you may feel confused and are helpless to do anything to spot them coming.
If you worry more than others, it could be because of your personality, current circumstances or your past or childhood experience; it could be a mixture of these.
If something distressing happened to you in the past, and you were unable to deal with your emotions at the time, you may become anxious about facing similar situations again in case they stir up the same feelings of distress.
Feeling anxious could also be something you learned early on in life; for example, your family may have tended to see the world as hostile and dangerous and you’ve learned to respond in the same way.
Some theories suggest that you may inherit a tendency to be more anxious, and so it is a part of your personality.
On a day-to-day basis, caffeine, excess sugar, poor diet, drug misuse, exhaustion, stress and the side effects of certain medication can also mimic and trigger symptoms of anxiety.
You may worry about the future. Sometimes, if you feel you are not in control of many aspects of your life, you can start to feel anxious about events beyond your control, such as the threat of global warming, of being attacked, of developing cancer, or of losing a job.
After a while, you can start to fear the symptoms of anxiety, especially feeling out of control. This sets up a vicious circle. You may feel anxious because you dread feeling the symptoms of anxiety, and then you experience those symptoms because you are having anxious thoughts.
Anxiety can have an effect on both your body and your mind.
Anxiety can make you more fearful, alert, on edge, irritable, and unable to relax or concentrate. You may feel an overwhelming desire to seek the reassurance of others, to be weepy and dependent.
The way you think can be affected: if you fear that the worst is going to happen, you may start to see everything negatively and become very pessimistic. For example, if a friend is late, you may imagine and worry that he or she has had an accident or doesn’t want to see you; even though your friend may simply be late because their train was delayed.
To cope with these feelings and sensations, you may feel tempted to start smoking or drinking too much, or misusing drugs. You may hold on to relationships that either encourage your anxious outlook or help you avoid situations you find distressing – and so stop you dealing with what’s worrying you.
If your anxiety is severe, you may find it difficult to hold down a job, develop or maintain good relationships, or simply to enjoy leisure time. Sleep problems may make your anxious feelings even worse and reduce your ability to cope. (See How to cope with sleep problems.)
For some people, anxiety becomes so overwhelming that it takes over their lives. They may experience severe or very frequent panic attacks for no apparent reason, or have a persistent 'free-floating' sense of anxiety. Some people may develop a phobia about going out, or may withdraw from contact with people – even their family and friends. Others have obsessive thoughts or compulsive behaviour, such as endlessly washing their hands.
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It’s tough to be productive in your daily life when anxiety and worry are dominating your thoughts. But what can you do? If you’re like many chronic worriers, your anxious thoughts feel uncontrollable. You’ve tried lots of things, from distracting yourself, reasoning with your worries, and trying to think positive, but nothing seems to work.
Telling yourself to stop worrying doesn’t work—at least not for long. You can distract yourself or suppress anxious thoughts for a moment, but you can’t banish them for good. In fact, trying to do so often makes them stronger and more persistent.
You can test this out for yourself. Close your eyes and picture a pink elephant. Once you can see the pink elephant in your mind, stop thinking about it. Whatever you do, for the next five minutes, don’t think about pink elephants!
How did you do? Did thoughts of pink elephants keep popping in your brain?
“Thought stopping” backfires because it forces you to pay extra attention to the very thought you want to avoid. You always have to be watching for it, and this very emphasis makes it seem even more important.
But that doesn’t mean there’s nothing you can do to control your worry. You just need to try a different approach. This is where the strategy of postponing worrying comes in. Rather than trying to stop or get rid of an anxious thought, give yourself permission to have it, but put off thinking any more about it until later.
Postponing worrying is effective because it breaks the habit of dwelling on worries in the present moment. Yet there’s no struggle to suppress the thought or judge it. You simply save it for later. As you develop the ability to postpone your anxious thoughts, you’ll start to realize that you have more control over your worrying than you think.
Research shows that while you’re worrying, you temporarily feel less anxious. Running over the problem in your head distracts you from your emotions and makes you feel like you’re getting something accomplished. But worrying and problem solving are two very different things.
Problem solving involves evaluating a situation, coming up with concrete steps for dealing with it, and then putting the plan into action. Worrying, on the other hand, rarely leads to solutions. No matter how much time you spend dwelling on worst-case scenarios, you’re no more prepared to deal with them should they actually happen.
If a worry pops into your head, start by asking yourself whether the problem is something you can actually solve. The following questions can help:
Productive, solvable worries are those you can take action on right away. For example, if you’re worried about your bills, you could call your creditors to see about flexible payment options. Unproductive, unsolvable worries are those for which there is no corresponding action. “What if I get cancer someday?” or “What if my kid gets into an accident?”
If the worry is solvable, start brainstorming. Make a list of all the possible solutions you can think of. Try not to get too hung up on finding the perfect solution. Focus on the things you have the power to change, rather than the circumstances or realities beyond your control. After you’ve evaluated your options, make a plan of action. Once you have a plan and start doing something about the problem, you’ll feel much less worried.
But what if the worry isn’t something you can solve? If you’re a chronic worrier, the vast majority of your anxious thoughts probably fall in this camp. In such cases, it’s important to tune into your emotions.
As previously mentioned, worrying helps you avoid unpleasant emotions. Worrying keeps you in your head, thinking about how to solve problems rather than allowing yourself to feel the underlying emotions. But you can’t worry your emotions away. While you’re worrying, your feelings are temporarily suppressed, but as soon as you stop, the tension and anxiety bounces back. And then, you start worrying about your feelings, “What’s wrong with me? I shouldn’t feel this way!”
The only way out of this vicious cycle is by learning to embrace your feelings. This may seem scary at first because of negative beliefs you have about emotions. For example, you may believe that you should always be rational and in control, that your feelings should always make sense, or that you shouldn’t feel certain emotions, such as fear or anger.
The truth is that emotions—like life—are messy. They don’t always make sense and they’re not always pleasant. But as long as you can accept your feelings as part of being human, you’ll be able to experience them without becoming overwhelmed and learn how to use them to your advantage. The following tips will help you find a better balance between your intellect and your emotions.
The inability to tolerate uncertainty plays a huge role in anxiety and worry. Chronic worriers can’t stand doubt or unpredictability. They need to know with 100 percent certainty what’s going to happen. Worrying is seen as a way to predict what the future has in store—a way to prevent unpleasant surprises and control the outcome. The problem is, it doesn’t work.
Thinking about all the things that could go wrong doesn’t make life any more predictable. You may feel safer when you’re worrying, but it’s just an illusion. Focusing on worst-case scenarios won’t keep bad things from happening. It will only keep you from enjoying the good things you have in the present. So if you want to stop worrying, start by tackling your need for certainty and immediate answers.
If you suffer from chronic anxiety and worries, chances are you look at the world in ways that make it seem more dangerous than it really is. For example, you may overestimate the possibility that things will turn out badly, jump immediately to worst-case scenarios, or treat every negative thought as if it were fact. You may also discredit your own ability to handle life’s problems, assuming you’ll fall apart at the first sign of trouble. These irrational, pessimistic attitudes are known as cognitive distortions.
Although cognitive distortions aren’t based on reality, they’re not easy to give up. Often, they’re part of a lifelong pattern of thinking that’s become so automatic you’re not even completely aware of it. In order to break these bad thinking habits and stop the worry and anxiety they bring, you must retrain your brain.
Start by identifying the frightening thought, being as detailed as possible about what scares or worries you. Then, instead of viewing your thoughts as facts, treat them as hypotheses you’re testing out. As you examine and challenge your worries and fears, you’ll develop a more balanced perspective.
|Cognitive Distortions that Add to Anxiety, Worry, and Stress|
All-or-nothing thinking - Looking at things in black-or-white categories, with no middle ground. “If I fall short of perfection, I’m a total failure.”
Overgeneralization - Generalizing from a single negative experience, expecting it to hold true forever. “I didn’t get hired for the job. I’ll never get any job.”
The mental filter - Focusing on the negatives while filtering out all the positives. Noticing the one thing that went wrong, rather than all the things that went right.
Diminishing the positive - Coming up with reasons why positive events don’t count. “I did well on the presentation, but that was just dumb luck.”
Jumping to conclusions - Making negative interpretations without actual evidence. You act like a mind reader, “I can tell she secretly hates me.” Or a fortune teller, “I just know something terrible is going to happen.”
Catastrophizing - Expecting the worst-case scenario to happen. “The pilot said we’re in for some turbulence. The plane’s going to crash!”
Emotional reasoning - Believing that the way you feel reflects reality. “I feel frightened right now. That must mean I’m in real physical danger.”
'Shoulds’ and ‘should-nots’ - Holding yourself to a strict list of what you should and shouldn’t do and beating yourself up if you break any of the rules
Labeling - Labeling yourself based on mistakes and perceived shortcomings. “I’m a failure; an idiot; a loser.”
Personalization - Assuming responsibility for things that are outside your control. “It’s my fault my son got in an accident. I should have warned him to drive carefully in the rain.”
How you feel is affected by the company you keep, whether you’re aware of it or not. Studies show that emotions are contagious. We quickly “catch” moods from other people—even from strangers who never speak a word (e.g. the terrified woman sitting by you on the plane; the fuming man in the checkout line). The people you spend a lot of time with have an even greater impact on your mental state.
Worrying is usually focused on the future—on what might happen and what you’ll do about it. The centuries-old practice of mindfulness can help you break free of your worries by bringing your attention back to the present. In contrast to the previous techniques of challenging your anxious thoughts or postponing them to a worry period, this strategy is based on observing and then letting them go. Together, they can help you identify where your thinking is causing problems, while helping you get in touch with your emotions.
Using mindfulness meditation to stay focused on the
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