EPTLet's talk anxiety!*
Specifically this will be oriented around people who get lots of physical symptoms from anxiety, but of course their can be other affects as well.
How Does Anxiety Develop?
What happens in people like you and I that are anxious? Well, we get stressed. But we get stressed (worry, fear, apprehension, concern, etc.) more often and to greater degrees than people without this issue due. So we get stressed, and before we recover we get stressed again, which brings us to higher stress, and then we don't recover fully from that which leads to the next round of stress....which all leads to a crazy stress background with far too much adrenaline, cortisol, and other key hormones. These all leads to a hyper stimulated nervous and musculo system that behaves erratically because it's so excited.
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Bottom line is this is all nervous system being overexcited. What happens is that every time you have any sort of stress, which is basically either fear, or apprehension/worry (which is basically fear) you get a little blast of stress. This is adrenaline. It's going to jump your nervous system and other things. If the stress is really big or long you'll also have cortisol and other powerful hormones that last even longer jumping in. In people with normal, healthy thought patters and no anxiety...they get stressed, then they relax. Big stressful two weeks at work? Usually followed with a week of less stress and lots of rest and relaxation. Their bodies return to healthy baseline. No symptoms or issues.
Why do *most* anxious people get anxious in the first place. Combination of alot of things. Some people are just more prone to, their amygdala or other aspects of their physiology just are more easily stimulated. Of course, rare cases can be caused by actual medical problems such as thyroid issues, adrenal tumors, etc. so if you have concerns those should be looked at. For everyone else though, it's how you learned to think about things. Anxious people have anxious thought patterns. An anxious person drives a car and has thoughts like:
Etc. Picture is clear. Underpinning anxiety are anxious or worry filled thoughts. A person without anxiety (or at least who isn't anxious driving) thinks:
That's the difference. Thinking and thoughts create anxiety. People without anxiety think differently across most situations than do people with it. Obviously, some with anxiety might have an area or discipline in which they are less anxious than a person with anxiety, but overall the anxious person will have a consistent thought pattern that is full of lots of doubt, concern, worry, fear, or negative thinking. They think about things that could wrong.
If you have anxiety, I guarantee you that you will find lots of examples in yourself about thinking this way. I guarantee it. This is the cause of that anxiety. If these thoughts don't change, the anxiety won't change. The good news is we control our thoughts (over time) and can change our thought patterns.
Why do *most* anxious people get anxious in the first place. Combination of alot of things. Some people are just more prone to, their amygdala or other aspects of their physiology just are more easily stimulated. Of course, rare cases can be caused by actual medical problems such as thyroid issues, adrenal tumors, etc. so if you have concerns those should be looked at. For everyone else though, it's how you learned to think about things. Anxious people have anxious thought patterns. An anxious person drives a car and has thoughts like:
Oh man, I'm going kinda fast. What if I lose control and the tyre blows out and I crash at 70mph
Damn, that dude next to me just moved his car over six inches, he's probably drunk and is going to crash into me. This could be very dangerous
Etc. Picture is clear. Underpinning anxiety are anxious or worry filled thoughts. A person without anxiety (or at least who isn't anxious driving) thinks:
FUCK YEA! I'm going 90 this wind in my face feels so good! My car is awesome.
Oh, hey. This guy just nudged over a bit. Probably jamming to some good tunes. If he did something really stupid I'm confident in my driving and I'll just move on the break and out of his way nice and controlled
That's the difference. Thinking and thoughts create anxiety. People without anxiety think differently across most situations than do people with it. Obviously, some with anxiety might have an area or discipline in which they are less anxious than a person with anxiety, but overall the anxious person will have a consistent thought pattern that is full of lots of doubt, concern, worry, fear, or negative thinking. They think about things that could wrong.
If you have anxiety, I guarantee you that you will find lots of examples in yourself about thinking this way. I guarantee it. This is the cause of that anxiety. If these thoughts don't change, the anxiety won't change. The good news is we control our thoughts (over time) and can change our thought patterns.
On Anxiety Physical Symptoms
Anxious people routinely have hyperrefflexia. Why? Nervous system is on high alert, it just triggers easily, quickly, and erratically. Nerves, of course, control everything. When they behave spontaneous and erratically weird shit happens. PVCs? Random firing of the vagus nerve in most cases. If Vagus fires, heart beats...it has no choice. So all that irritability makes the vagus fire super easily. Bam. PVCs.
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Of course, this can happen anywhere. Headaches? Yep. Twitching? Yep. Cramping? Yep. Tingling/Numbness/Pins and Needles? Yep (random sensory nerve signals firing). Gut issues? Yep. Gut is hugely connected to parasympathetic tone. Tremor? Yep. Tinnitus or amplified sensations of pain/sound/light? Yep (brain becomes overly attuned to specific nerve signals). Etc. Etc. Etc.
The amount of stuff anxiety can do to the body is FUCKING INSANE. It's stupid. I've literally had over 100 different symptoms. Some of them really, really fucking weird ones. Shit you wouldn't in a million years imagine is possible if you haven't had somatic symptoms from anxiety. Also incredible about anxiety is what a fucking asshat chameleon it is. Just when you think you have one symptom under control....BAM....something new:
That's just what anxiety does.
The other asshole trick anxiety plays is the way it can hit you when you're not anxious at all. I'd have days where I'd be pretty damn calm and then bam, I get a run of 45' of 20 PVC's every minute:
NOPE. It's anxiety. Why? How? Hyper stimulation. In most cases it takes weaks, and in stronger cases months, (not years though from anything I've ever heard) to get your nervous system back to normal. Until then you can have random symptoms anytime, anywhere. Your nerves just do random shit because they fire easily. This can, quite literally, cause you to feel or experience anything.
This has to be stressed, because the only way out is to accept that ALL of your symptoms are anxiety, and to move on with them. Anytime you doubt "maybe their is something wrong with me" and go down that road you'll get blasts of stress. Then your nervous system stays stimulated and you keep getting weird symptoms.
The amount of stuff anxiety can do to the body is FUCKING INSANE. It's stupid. I've literally had over 100 different symptoms. Some of them really, really fucking weird ones. Shit you wouldn't in a million years imagine is possible if you haven't had somatic symptoms from anxiety. Also incredible about anxiety is what a fucking asshat chameleon it is. Just when you think you have one symptom under control....BAM....something new:
"Oh you were worried about your heart....haha fuck you guess what now you're foot is going numb randomly and your legs are wobbly. Welcome to thinking you have MS motherfucker!!".
That's just what anxiety does.
The other asshole trick anxiety plays is the way it can hit you when you're not anxious at all. I'd have days where I'd be pretty damn calm and then bam, I get a run of 45' of 20 PVC's every minute:
"Well, fuck. I was calm so this can't be anxiety right? I have to have something wrong with me then....".
NOPE. It's anxiety. Why? How? Hyper stimulation. In most cases it takes weaks, and in stronger cases months, (not years though from anything I've ever heard) to get your nervous system back to normal. Until then you can have random symptoms anytime, anywhere. Your nerves just do random shit because they fire easily. This can, quite literally, cause you to feel or experience anything.
This has to be stressed, because the only way out is to accept that ALL of your symptoms are anxiety, and to move on with them. Anytime you doubt "maybe their is something wrong with me" and go down that road you'll get blasts of stress. Then your nervous system stays stimulated and you keep getting weird symptoms.
Anxiety Begets Anxiety
The extra bad kicker about anxiety is it's a nasty cycle. Anxious people usually have insomnia of some kind because they are too wired to sleep well, sleep requires relaxation. Insomnia cuts into your R&R (rest and recovery) time, and promotes more anxiety. Moreover, anxiety promotes anxiety. When you're more anxious, you jump and startle easier, are more prone to emotional thinking, and have stronger emotional responses. If I sneak up behind you in a room where you're relaxed with friends playing some video games and go "BOO" you might mildly startle, but it won't do much. If I do this in the woods where you think you heard a bear....you're going to SPOOK, and spook hard.
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This means that as an anxious person you accumulate and reinforce both stress and bad thought patterns much easier. Compare the difference between being mild concerned at a part of a trail that there was a mountain lion. Maybe you thought somewhere in the back of your head you heard something that sounded like a mountain lion sound. But it was midday, many people around, and turned out not to be a big deal at all. You might remember that tomorrow, but it's basically forgotten a few days later. Now compare to you being alone at dusk, on the same trail, and are startled by an actual mountain lion that roars(is that we call it?) at you from behind before eventually slinking away. Guarantee your shook up the entire rest of the night. Moreover, you will basically NEVER forget that part of the trail and will probably always experience some fear every time you pass by their.
What gives? Well, neural circuits are formed by thinking and by responses. Ones that are used more often are reinforced, those that aren't used as often are "pruned" away and cease to exist or have the connections become fewer and weaker. In the presence of greater stress/fear response, neural circuitry is reinforced to a much greater degree, hence the difference in the mountain lion response.
So, under stress/anxiety/fear we both further reinforce thought processes of fear or anxiety both because we are more prone to not use logic (because we are anxious) and because when anxious their is a stronger response that further reinforces anxiety.
This is all important too because it explains getting anxious for "no reason". We don't control individual thoughts, these "randomly" generate all the time. We control thought patterns. When you get anxious for no reason, it's basically a result of remember thought patterns. Something in your environment reminded you, in some manner, of a time when you were anxious before and at some level your brain recalled that and fear response was triggered
What gives? Well, neural circuits are formed by thinking and by responses. Ones that are used more often are reinforced, those that aren't used as often are "pruned" away and cease to exist or have the connections become fewer and weaker. In the presence of greater stress/fear response, neural circuitry is reinforced to a much greater degree, hence the difference in the mountain lion response.
So, under stress/anxiety/fear we both further reinforce thought processes of fear or anxiety both because we are more prone to not use logic (because we are anxious) and because when anxious their is a stronger response that further reinforces anxiety.
This is all important too because it explains getting anxious for "no reason". We don't control individual thoughts, these "randomly" generate all the time. We control thought patterns. When you get anxious for no reason, it's basically a result of remember thought patterns. Something in your environment reminded you, in some manner, of a time when you were anxious before and at some level your brain recalled that and fear response was triggered
The Big Picture
So, now we are starting to get the bigger picture. There are problems with thinking that lead to to much stress response, that eventually overwhelms us and keeps increasing our baseline level of stress higher and higher, which only increases how fearful, stressed, and anxious we get, causing stronger responses and more stress and further reinforcing thought circuits in our head that beget this anxiety.
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This is how anxiety develops in most people that don't have actual health conditions, severe trauma, etc. that created a rather immediate anxiety. I'd also like to note that this can apply to people that are stressed out, and feel wierd things, but wouldn't identify or consider themselves as "anxious". Yes, perhaps not anxious. But you do have thought patterns and concerns over too much workload and the effects of what is going on, combined with lack of sleep, that is leading to all that stress response, which has you hyper stimulated and thus having random physical symptoms.
The difference between someone with anxiety and someone who is stressed and feeling wierd stuff in their body is the stress person says "EH, it's stress. Whatever". The person with extreme anxiety thinks "holy shit my foot just vibrated I have MS my life is fucked".
The difference between someone with anxiety and someone who is stressed and feeling wierd stuff in their body is the stress person says "EH, it's stress. Whatever". The person with extreme anxiety thinks "holy shit my foot just vibrated I have MS my life is fucked".
So Uhh....What do we do?
So, we need to do two things:
1) Do something to relieve the current over-stimulation. Basically, we need R&R.
2) We need to break the bad though patterns that lead to hyper-stimulation in the first place.
Relaxing The Body: Allowing Recovery
It's imperative we start getting some R&R time. Now, as anxious people, we know that for most of us our sleep is fucked so we aren't getting it there. What to do?
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- R&R Quiet Time - Schedule at LEAST 1, but ideally like 2 or 3 times where for 30' each day you're going to just relax. Sitting or lying is fine. Quite, not overly bright area. The goal here is just a state of deep relaxation. At first, this is going to seem basically impossible. Your body is NOT going to want to relax. That's OK. Do your best. Any form of meditation or quite relaxation will work. Progressive muscle relaxation is good. I did something where I would visualize each letter of the alphabet for perhaps 30-45s going up halfway, then from 10' I would just be peaceful focusing on the most relaxing, comfortable thoughts I know about. Then finish focusing on visualizing the rest of the letters one at a time. Other thoughts will intrude. Perhaps forcefully. Don't get upset (we wan't to relax after all). Just note them, then let them go and go back to your visualization. It will improve with time. When I first did this, I spent 90% of the time letting thoughts go and 10% actually visualizing. I combined this with trying to make my body feel as "heavy" as possible, releasing all tension. Personally, I liked doing this at lunch, right when I got back from class/work, and then once an hour or so before bed.
- Deep breaths are your friend. Everytime you think about it or feel a little anxious do one big deep breathe. 4-5 seconds in, filling up both your chest AND your stomach, hold for 2 seconds or so, and then nice slow 4-5 seconds exhale. Let your tension go with this. Anything to break anxious cycle responses.
- Sleep. This is huge. I know most sleep stuff recommends minimal napping. This is probably true, but for anxiety I think it's different. What your body needs is relaxation and rest, as much as it can get. You're tired as shit. You're not sleeping poor because your sleep hygiene is bad, you're sleeping poor because you're too wired. Nap and relax anytime you can. Laziness is your friend. When you start to relax, you WILL sleep because you're crazy tired. When you start to feel good on sleep and much more relaxed, then drop the naps and worry about sleep hygiene. Naps are relaxing. Use them anytime you feel like it and can.
- Sleep Attitude. Anxiety and insomnia go hand in hand. We know this. But the kicker is, sleep is a natural process, the body wants to sleep. The reason it doesn't is because you're too wired. Those of us with insomnia tend to be concerned about sleep. "Are we getting enough?" "Fuck this is annoying" "Damn I hate not being able to sleep" "Will this ever end?" "Fuck what if it gets worse?!". This is how everyone, including myself, with insomnia that I knew felt/feels. Well, what happens when you go to bed or wake up then. You're tired, but now you have a habit of every time you go to sleep of thinking "shit I might not sleep well. I don't like that".
Bam. Worry. Concern. Stress response. No sleep. GGNORE. If you want to improve the insomnia, it's imperative and essential you stop caring about actually sleeping. Sleep doesn't matter here. Rest and relaxation does. Make it your go to just go to bed and relax. Learn to enjoy just being in your bed relaxing/meditating/etc. Stop caring if you sleep. If you fix those bad mindset patterns you won't create anxiety around sleep and will fall asleep much better, especially as overall hyper-stimulation decreases. A huge part of insomnia is created, or rather sustained by, poor bedtime thought patterns, at least in every insomniac I've known.
Changing Our Thought Patterns
Alright, so we have some techniques to start giving our stressed, anxious body a chance to recover. That's good, but if you're like me or anyone I've ever known with anxiety, you started out with a normal, non overstimulated body and still got anxiety. Just relaxing isn't enough to banish anxiety. The thoughts have to change.
This is a difficult topic but for me it's about several steps:
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- Stopping The Response: Goal number one has to be to stop that anxiety response as quickly as possible. The further it goes and the stronger it is allowed to be...the greater the stress and the greater the reinforcement of those bad thought pattern neural circuits. The first thing you need is a way to kill or reduce the anxiety when you start to feel it. Deep breathing. 5 or 6 giant vacuum breaths and hold. Meditation. Thinking
calm(ing) thoughts. Reminding yourself that it's just anxiety, it can't hurt you even if it doesn't feel good, and that it will go away when you're calm. Progressive muscle relaxation. Square breathing. Etc. All of these are techniques you can use. We are all individuals, so which ones suit you best work for you.
The goal of this step is to break the response circuitry. Here, we want to change the thought process from: random/known cause anxiety -> "OMG this isn't good. I don't feel good. Maybe something is wrong or this will get worse" and change it to: random/known cause anxiety -> "It's okay, this isn't dangerous. It's anxiety and will pass when I am relaxed. I have the skills to handle this situation"
In this manner, you slowly break the cycle of runaway or sustained anxiety to a more normal one of: ANXIOUS! -> It's Okay -> Calm.
Rather than: ANXIOUS -> ANXIOUS, don't feel good -> ANXIOUS -> STILL ANXIOUS -> FUCK IF I'M STILL ANXIOUS SOMETHING MUST BE WRONG -> HOLY SHIT I'M DYING!!!
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- Changing the Thought Patterns: So, now we can at least stop the anxious response and keep it a little contained. But, we still have all these thoughts generating anxiety. Perhaps now instead of: Driving is scary, I could crash -> anxiety -> tense -> jerkier movements -> car handles worse -> driving is scarier -> INCREASE anxiety -> repeat
We have : Driving is scary I could crash -> Anxious -> It's okay. I'm just anxious -> Relax a bit -> Driving is scary, I could crash -> repeat
We still have to kill the first part. This will require some soul searching. You're going to need to think about what are the things driving your anxiety. What situations scary you, worry you, have you low in confidence, etc. You'll want to go deeper and figure out what is the "true" fear. For example:
Public Speaking -> Afraid of messing up. Why? -> Will look stupid -> Why is this scary? -> People will think I'm stupid
Bam. We have an answer. You're afraid of making mistakes. Why? Because you will look stupid. At it's core, you have a fear problem. You're much more afraid of making mistakes and "looking stupid" than a person typically is. You'll want to examine why you feel this way, and start reframing and reshaping those deep thoughts. Embracing and thinking about worse case scenarios can often help, because you realize they aren't actually that bad in most cases.
This will take time and effort, but you need to kill both the "deep" fear and the outer fears. Eg. both the "I'm afraid of making a mistake speaking" AND the "I'm afraid of looking stupid.
If you had hypocondriasis type fear, likely you're afraid of either death, pain, or of losing your ability to move around. You need to address both the irrationality of these fears "There is a VERY slim chance what is causing my headache is an aneurysm. I'm probably just anxious" and the underlying fear (e.g. I could have an aneurysm -> could lead to death). In some cases, such as the hypochondriases type one, you'll have to develop a passive acceptance that "yes their is a small chance something could be seriously wrong with me. I don't obsess over dying in a car accident (1 in 100 ish lifetime risk), so it's absolutely ridiculous I obsess over my chance of having a rare fatal brain aneurysm.
Summary
So in the end getting rid of anxiety is about:
- Getting R&R
- Changing to Healthy Thoughts About Sleep
- Acceptance of Some Level of Risk + Acceptance That You Will Have Random Anxious Moments and It Will Take Some Time To Resolve Completely
- Controlling & Preventing Runaway Anxiety + Minimizing Anxiety Response
- Addressing both superficial and "deep" fears
- PRACTICE
All of these are skills that take time and practice to develop. I, and probably you, didn't develop anxiety overnight. It was built over years and decades. It's entrenched deep in our thoughts. It takes time, effort, and focused practice, just like StarCraft, to reduce and eliminate.
Best Wishes!
*For those wondering, this is primarily an experience blog, presenting my mental picture I developed of anxiety. This is a mental model that worked incredibly well for me, and for many others. Much of the stuff in here is literature supported and well backed with evidence. However, I cannot guarantee that all of it is. So, to be clear, I'm not presenting this as "cutting edge science" anxiety blog. It's a mental model that I developed after several years of struggling with this and never understanding how to make it go away. It just wouldn't quit and always had new faces. It came after a combination of tons of research, talking with counselors/psychologists, talking with everyone and anyone I knew who had dealt with anxiety, and much of my own thoughts and reasoning. I hope you find it helpful.
