all about anxiety 

all about anxiety 

What is anxiety???

Anxiety, first and foremost, is not an emotion.  It's a physiological state.  Let's be clear, because this is important: anger, fear, happiness, and sadness are all emotions.  Anxiety is not.  It's a physiological state.  Our bodies are responding to something, and we are experiencing that as anxiety.  What is that something we are responding to?

A mentor of mine once said that "anxiety is the thing we feel instead of the thing we should probably be feeling instead". 

If this is true for your anxiety, which feeling might that be?

In most cases, that emotion is fear.  

So why isn't everyone talking about having a fear problem instead of an anxiety problem?  That's actually a very good question.  Part of it is cultural: there's been a lot of press about anxiety.  Anxiety is everywhere, everyone's got anxiety, so anxiety is a thing now.  And on top of that, most psychological jargon is focused on anxiety, because these things are all topically indexed as anxiety disorders.  Well, technically that's not wrong: anxiety is, after all,  the primary symptom we are experiencing with these fear problems,.  But to say we have anxiety problems doesn't at all explain what is going on underneath, and it doesn't explain where it comes from, and it certainly doesn't explain what to do about it.

So what is going on?  Well, let's break it down a bit.  For just a moment, let's talk about a different concept: Excitement!  It's more fun to talk about, but beyond that, this will also serve to make sense of anxiety.  Here we go.  

 

I think most of us will agree on this as a definition of excitement: excitement is the anticipation of a positive event. Remember how I was saying that anxiety is not an emotion but is instead a physiological response to a perceived experience?  Well, that's the case with excitement too.  So, technically speaking, excitement is the physiological response to the perception of an anticipated positive event. Agreed?  Good.  Not sure?  Read on...

 

Here's an example: You're at home and you are checking your lottery ticket.  You aren't actually expecting that you've got the big winner in your hands.  But then...the first number checks out, then the next, and you've got 4 in a row!  What are you noticing?  Your heart begins to beat faster, your rate of respiration increases, you might begin to sweat a bit, but it's all kind of pleasant because we're anticipating something pleasant, right?  Well, guess what... this is exactly how anxiety works.... except that it is technically the opposite of excitement: it is simply the anticipation of a negative event.  But then there's all the symptoms.  Yuck.

What are the symptoms of anxiety?

They can vary somewhat for different people, but the range of symptoms people usually talk about includes:

  • fear or panic

  • perception of being out of control

  • constant worrying and/or catastrophizing (thinking the worst is going to happen)

  • obsessive thought processes with or without compulsions to do things about those obsessions

  • tightness in chest or occasionally belly or neck

  • difficulty thinking clearly/objectively

  • irritability

  • tingling in fingers, toes, or face

  • redness in face

  • "heavy" feeling in limbs

  • pressure in face or head

  • inability to talk yourself out of it

  • "fight, freeze, or flee"

  • oftentimes thoughts are irrational or unsupported by facts/logic, but even knowing that doesn't help​

Other things that frequently accompany problematic anxiety:

  • substance use and other addictions (as a means of trying to escape the negative feelings)

  • procrastination and avoidance (to avoid the sensations)

  • controlling behaviours (to feel we have control over the sensations)

  • anger problems

  • high blood pressure

  • persistent restlessness

  • depression

  • isolation

  • shame

  • historic trauma

  • diagnoses of ADD/ADHD/OCD/ ODD/PTSD (and others)

what are the main anxiety diagnoses/disorders?

According to the Fifth (current) Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the following fall under the classification of anxiety disorders:

  • Generalized anxiety disorder

  • Substance/medication-induced anxiety disorder

  • Agoraphobia

  • Specific phobia

  • Social anxiety disorder (social phobia) 

  • Separation anxiety disorder

  • Selective mutism

  • Anxiety disorder due to another medical condition

Note:  Technically, Obsessive-compulsive disorder (OCD), posttraumatic stress disorder (PTSD), and acute stress disorder were previously grouped under the Anxiety Disorders heading, but are now no longer technically considered true anxiety disorders.  They are, however, still considered to be similar in terms of brain processes involved and share similar treatment implications.

treatment: what to do about it?

The first thing your anxiety counsellor will want to do is to get a bit of the history of your anxiety:  How long has it been going on? What are your symptoms?  What helps?  What makes it worse?  We'll want to get a fairly accurate idea of what we're dealing with.  

Next, we'll come up with a plan together with you.  That plan typically addresses the physiological, emotional, cognitive, and behavioural aspects of your particular anxiety struggles.

Anxiety counselling will likely involve some Cognitive-Behavioural Therapy (and yes, that probably means some homework to build momentum between sessions!).  That stuff we were talking about earlier, about the ways in which we tend to anticipate negative things?  We'll really dig into that.  We'll look at learned patterns like catastrophization, all-or-none thinking, the concept of "dress rehearsing" (preparing for and playing out the worst case scenario), etc.  We'll also make sure to give you plenty of new strategies, tools, and tips to help you face the anxiety when it rears its ugly head.

  

We may also discuss options regarding medications (SSRI-class medications are those most likely to be prescribed by your doctor or psychiatrist).  Remember, we are not able to prescribe medications, but we would gladly consult with your doctor regarding your medication needs.  

Anxiety feels AWFUL.  But there's a lot of hope.  Many of our clients have found incredible relief after going through just a few weeks of anxiety therapy.  Talk to us if you'd like more information about how we can help you to feel better and get over these problems of fear, dread, and worry!

The Therapy Place

COUNSELLING

       GROUP LTD

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#309, 477 Wallace St.

Nanaimo, BC, Canada

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