Anxious about being anxious? Part I

By Dr. Batya Ludman · Published February 6, 2015

While some anxiety is healthy, perfectly normal and inevitable, people often come to see me when anxiety becomes overwhelming and negatively impacts their daily life and physical and emotional health.

Although we all experience stress and anxiety, we each perceive it differently. How we choose to deal with it will, in part, determine how effectively we cope.

Anxiety is an abnormal and all-consuming sense of worry and fear; it is often marked by physical symptoms such as rapid breathing, racing pulse, sweating and muscle tension. You may have an unrealistic and irrational understanding of the nature of the perceived threat, and will often doubt your own ability to cope with it. Anxiety can interfere with your capacity to pay attention, focus, concentrate and filter out irrelevant and unimportant information. When not in check, it can feel like these emotions are taking over your life, leaving you sad and even truly depressed. Untreated, anxiety can interfere with work, school, interpersonal relationships, social functioning and your mental and physical well-being.

Note: I am using the words “stress” and “anxiety” interchangeably here, although they are not quite the same. Remember, if you tend to have an unhealthy or stressful lifestyle, it is probably making you anxious, and if you are anxious about something, it is most likely stressing you out.

Treatment for anxiety usually revolves around correcting or reframing “irrational” beliefs, strengthening your coping techniques and sometimes treating your symptoms with medication to alleviate suffering. In spite of this multi-pronged approach, success can be limited, as valid treatment often requires more than just talk or pharmacotherapy. Those suffering from it not only have to deal with their thoughts or worries, but often feel physically unwell – and this too must be addressed.

Working extensively in the area of trauma, I’ve learned to appreciate the vital role the mind/body connection plays in effective therapy; our thoughts and feelings can greatly influence our physiological state, and vice versa. So while thoughts are crucial, what gets many clients through my door are their horribly uncomfortable feelings of imminent danger and the foreboding sense of unease, as well as other bodily sensations such as a racing heart, dry mouth, tingling, nausea, dizziness and other physical symptoms that mimic everything from heart disease to diabetes.

When your body responds, it often doesn’t distinguish between a real or perceived threat, or recognize the difference between a less significant stressor such as delivering an oral presentation to a group of colleagues and seeing a car coming at breakneck speed towards you in the wrong lane. That means your nervous system’s fight-orflight arousal response can be the same in both circumstances, sending your body into overdrive and causing tremendous anxiety and distress.

Today, we recognize that lengthy “talk therapy” alone can be overwhelming, cause further re-traumatization, and may leave you feeling even worse. It may not be enough to simply intellectualize your anxiety; you may need to do something – achieved through greater awareness and understanding of what is going on in your body as well as your mind.

Animal models of coping with stress, along with greater neuroanatomical and radiographic understanding of the limbic system, have taught us the tremendous importance of also working with the body’s non-verbal response to perceived threat or danger. That is why effective treatment focuses on helping you learn to notice, listen and achieve greater awareness of body sensations, in a way that helps you quickly calm down your nervous system’s response; be physically less anxious, angry, sad, withdrawn or overwhelmed; feel safe and strong; and have a greater understanding of the thoughts that trigger your hyperarousal.

No longer feeling flooded by an excess of stress hormones, you can now work directly and quickly through your body to get back a sense of control, rather than feeling controlled by the anxiety itself. This leads to shorter, more efficient treatment with you feeling more empowered by having tools to deal with daily stress, trauma, pain, depression and much more.

The initial assessment visit may include getting information about how you feel, identifying the sources of past and current stresses and what maintains them, as well as a description of your symptoms, what brings them on and what makes them better or worse. Part of this visit involves psycho-education, or learning about your body’s normal response to stress, along with a greater understanding and awareness of your own strengths, natural resources and available support.

Some people know just what makes them anxious, whereas others are unsure. The focus is on ascertaining what triggers your anxiety and helping you work with it to feel better through cognitive behavioral therapy, stress management techniques and appropriate somatic therapies.

For many, the discovery that even after a single session, you have the ability to begin to heal yourself and can leave with tools that you can practice at home, is already comforting. These exercises may involve breathing, touch, movement and tracking physiological arousal, and employ various means to reduce and eliminate symptoms through relaxation, mindfulness work, and other self-soothing and calming techniques.

We now know that long-term stress and anxiety can actually rewire the brain, leaving you more vulnerable to emotional and physical problems; we also know that learning to manage your stress by attaining control over many aspects of your life can be life-changing. Next time, we will review just what you can do to care for yourself.

Isn’t it time you began to take charge and feel better?

A version of this article suitable for printing is available here.