troubled-minds - what is anxiety?

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Anxiety is a basic, natural response to any perceived danger; it is our body's way of telling us that we are encountering - or about to encounter a potentially harmful situation and that we need to take action to avoid it.

Everyone at sometime in their life feels fear, nervousness, dread, anticipation, etc. These are all terms for varying degrees of anxiety and, whether it is caused by standing on the edge of a cliff, singing on a stage, or an idea that you may be ill, the resulting emotions and your biological responses to them will be roughly the same. The mind and body will unconsciously gear themselves up for what psychologists call a "fight or flight" response, in which you prepare to either run for your life or stand your ground and defend yourself.

Anxiety only becomes a problem when we perceive danger at times when there is no real danger or when the anxiety continues long after the possibility of any danger has passed and we end up either living in fear or adapting our behaviour to avoid potentially frightening situations.

Of course, with real dangers there is usually a visible course that events are taking and there are usually clearly defined beginnings and ends to the dangerous situation. In the example of a barking dog running towards you, the owner might grab it and put it on a lead. This would signal the end of the danger and, even though you might still feel a bit shaken, you will start the process of calming down. Someone who is anxious about taking their driving test might be able to calm themselves with the thought that it will all be over an hour from now. Unfortunately, with imagined dangers, there are no such events to act as indicators and so the anxiety has no time-limit.

Another difference between 'real' anxiety and 'perceived' anxiety is that in a genuinely dangerous situation we know what the danger is and we know that it's natural to be scared of it. When the danger is purely perceived we tend to view it - and ourselves - very negatively. We may feel stupid for being scared and berate ourselves for it. We might imagine that we are going mad because we can't face situations that many people take in their stride. One thing that we invariably do is to ask ourselves questions about it: why am I feeling like this, what's wrong with me? These questions give our imaginations carte-blanc to come up with equally terrifying answers and a spiral of anxiety begins. This spiral can occur very quickly and without any real conscious warning; this is when anxiety becomes a panic-attack.

how it all started

To explain what anxiety really is we have to go back thousands of years to a time when the way that humans lived wasn't that far removed from the way wild animals lived. In these primitive times we had a very basic existence with no knowledge of the science of the world and very poor communication skills. Disputes would have been settled by fighting - very often to the death - and things like thunder storms were completely beyond our understanding. We would have been prey for many predatory animals and the act of hunting for our food and clothing would have very often put us in mortal danger.

In these dangerous times we developed a number of psychological, neurological and physiological mechanisms for equipping us to either do battle or to flee (fight or flight). These mechanisms all played a useful role in helping us to defeat or evade the danger by making us stronger, faster, lighter, more scary and more alert. The reactions we developed to help in these situations had to happen subconsciously and we had very little or no control over them. This was a biological necessity because at times of danger we didn't have time to think about our actions and any delay could have proved harmful or even fatal.

...but I'm not a caveman

Evolutionary change is very slow - the transition from homo habilis to the modern form of human being took over 2 million years but societies, as we know them today, in which we don't have to hunt for food and we have the protection of houses, have only been around for a couple of thousand years. In fact, if we scale the evolution of mankind down to an hour, we have only lived in relative safety for the last two or three seconds. Therefore, it is easy to see how we haven't had enough time to lose these primordial characteristics.

In modern times we are faced with a different set of dangers, many of which aren't life-threatening but would have an impact on our health, wealth, quality of life, social standing, etc - things that we hold dear in the context of modern living - and, while many of the primitive reactions to danger are no longer required in these situations, we still have them and they are still triggered in the same way.

The trigger for these reactions can be something real, such as a growling dog, or something harmless that is perceived to be a danger, such as a sudden noise or an unfamiliar physical sensation. The subconscious mind has no power to rationalise and therefore can't tell the difference between a danger that is perceived via the senses and one that is perceived via the imagination, so in both cases the reaction is the same. Of course, the danger is not always real and people who are prone to experiencing anxiety in non-dangerous situations are said to have an 'anxiety disorder'.

so what actually happens?

At times of anxiety the hypothalamus in the brain releases a chemical called Corticotropin Hormone Releasing Factor (CRF), which in turn stimulates the pituitary gland to release another chemical called Adrenocorticotropic Hormone (ACTH), which then triggers the adrenal glands (located above the kidneys) to release adrenaline and noradrenaline into the blood. This change diverts blood away from the skin and digestive system and into the major muscles of the arms and legs and to the liver and the brain. Receptors in the lungs detect these changes and the respiratory rate is increased to ensure that enough oxygen is carried to the muscles. The increase in adrenaline causes heightened muscle tension and salivation is decreased to retain fluid for cooling the body. The pupils dilate to allow more light in and the other senses become more acute. The tiny muscles at the base of the hairs contract causing the hair to stand on end (this would have made our much hairier ancestors appear bigger and more frightening). The bladder and bowels feel the urge to empty to reduce weight and the level of blood-sugar increases to boost energy.

None of these things happen by accident; they are all controlled by part of our Autonomic Nervous System called the Sympathetic Nervous System - and in the normal course of events, when the danger has passed, the Parasympathetic Nervous System takes control and restores the body functions to their usual state.

It is important to remember that the changes we encounter in response to anxiety are only temporary.

why me?

This is a question that we can't answer.

The reasons that we develop anxiety are probably as varied as our own individual characters: some people believe that there is a genetic factor and other people believe that it is purely learnt behaviour.

Some people believe that emotions from our past have to be resolved in order to progress and others believe we should forget the past and concentrate on our present actions.

positive feedback loops

A positive feedback loop occurs when two things amplify each other, like in the case of a musician who holds his microphone too close to a speaker. The sound of the speaker is picked up by the microphone which then amplifies it and sends it back through the speaker to be picked up by the microphone again. The result being a deafening, high-pitched whine.

The same thing happens with anxiety: once something has triggered the anxiety, the sufferer may experience unfamiliar or worrying thoughts or physical sensations, which in turn serve to heighten the anxiety further and create more strange sensations... and so the loop is created.

When someone experiences anxiety, a large proportion of the fear that they feel is generated within themselves as a response to the unfamiliar sensations they experience. This is because the mind starts to ask itself questions such as, "what is wrong with me?" and the imagination has free reign to come up with an answer. The answer it very often comes up with is "I must be ill," and, in time, this becomes ingrained as an undeniable fact in the mind.

Many anxiety sufferers are absolutely convinced that they are seriously ill, despite the fact that there is no medical evidence to back this up. Once a person reaches this state they will actively look for things that might be physically wrong with them to reinforce their belief - another positive feedback loop.

relaxation

Many anxiety sufferers find it almost impossible to relax, even for a couple of minutes. They seem to develop a feeling that they always have to be on their guard and in control and that if they stop worrying about the perceived danger - no matter how briefly - they will be vulnerable to it.

Trigger
In my own experience, anxiety can be triggered by anything from a door slamming to a television programme about hospitals to an unfamiliar physical sensation in your leg, but whether it is a sensory experience (sight, sound, smell, taste or sensation) or a spontaneous idea, it is invariably your perception of the trigger that initiates the anxiety. These perceptions are created internally from our own experiences and expectations and each of us will have a different perception of any given event.
Example 1
Mary is sitting in the house at night and she hears the front-door open. Her husband is working away and she has been sitting in the dark watching a horror film. She is terrified by the noise because she isn’t expecting it and she instantly interprets it as something very bad.
Example 2
Mary is sitting in the house at night and she hears the front-door open. Her husband went out five minutes ago to get some milk from the shops and she naturally assumes that it is him returning and therefore, a good thing.

In both of the above examples, the physical event (the door opening) and Mary’s sensory experience of the event (hearing the door open) are exactly the same, but the contexts of the experiences in her mind – i.e. her perceptions – are poles apart. The same is true of everything that you experience, be it sensory or imagined, the only meaning it can possibly have is the meaning that you give to it.

This can be illustrated on a much more fundamental level if you imagine there was somebody out in the street shouting. You might look through the curtains to see what the commotion was but generally speaking you’d ignore it – unless it was your name they were shouting. This would create a completely different meaning to the situation in your mind and your thoughts, emotions and actions would be driven by your new perception.

Now, just because it is you that is creating the perception, that doesn’t mean you are doing it consciously – and more importantly – just because you are doing it unconsciously, that doesn’t mean you can’t stop it. It is generally accepted in the field of psychology that we are born with two fears: a fear of falling and a fear of loud noises. Everything else you fear is only a fear because you have learned to fear it by assigning a meaning to it and, while it may be difficult or even impossible to unlearn it, it is possible to learn to assign a different meaning.

I have experienced hundreds of panic attacks and on a lot of occasions I don’t even know what the trigger is, let alone what perceptions I have formed. It may be that the process happens so quickly that your conscious mind doesn’t notice it; it may be that the original trigger gets lost in the avalanche of thoughts that follows – who knows? The important thing is that it takes practice to form more pleasant perceptions. When somebody asks you your name you don’t have to think about it because you have practiced it all your life. That doesn’t mean that no mental process takes place; it simply means that you didn’t have to subject your conscious mind to the process of retrieving your name. The same can be achieved with the subconscious process of forming perceptions.

Can I Dismiss?
The question of whether you can dismiss a negative thought before it develops into anxiety or at any point during the anxiety cycle depends on a number of factors. First of all there is the level of importance that we attach to an experience when we form a perception, or in other words, the perceived effect that it will have on our lives. Again, this will differ from person to person based on our previous experiences. If you were bitten by a dog as a child, you are much more likely to consciously notice the sound of a dog barking than you are to notice the sound of a bird singing because you have learned to attach a much higher degree of significance to the former. Conversely, if you are a keen birdwatcher, you are more likely to notice the bird singing as subconsciously that is more important to you.

Your state-of-mind at any given time will also affect your ability to dismiss negative thoughts and the level of significance you give to the perception. This will be determined by several factors such as:
• Physical tiredness
• Illness
• Hunger
• Mood
• Preoccupation
• Self-image
• Self-confidence
• Surroundings
You may wake up one morning with a headache and think nothing of it, whereas on a different morning, in a different frame of mind, you might be convinced that you have a brain tumour.

The above factors will affect your initial reaction to your perception, and even the formation of the perception itself, but there are also factors that will come into play as we start to ask ourselves questions about the negative thought during the anxiety cycle. See the Questions section below.

Have I Reached My Limit?
Everybody has a limit beyond which anxiety will not escalate. It may not feel like it when you are in the grips of a panic attack but, if left unchecked, the mind will eventually start to decrease anxiety on its own. I don’t know if this is because it cannot adequately concentrate on the anxiety anymore, or because the brain grows tired of it, or because the body’s parasympathetic responses cause chemical changes to suppress it – whatever the reason, be assured that it does happen.

Questions
The perpetuation of anxiety is largely governed by the questions that we ask of ourselves about that anxiety and the (often irrational) answers that we provide to those questions.

Asking questions is natural when you’re not sure what’s happening and it is a very good way to train the mind but the questions we ask about anxiety very often bring answers that lead to more questions and greater anxiety. This is not always the case; sometimes we will ask a question – and provide an answer – that does satisfy our need to know and reassure us about our negative thoughts. When this occurs the satisfactory answer will affect the ‘Can I Dismiss’ question.

The problem with the questions we ask is that they are vague and open to subjective rather than objective interpretation. For example, one of the first questions we ask on experiencing a physical sensation may be, “what’s wrong with me?” Now there’s no way we can be absolutely sure of the condition of our whole bodies so we rely on what little evidence we have and a lot of imagination to answer the question – and when left to the imagination, a question like “what’ wrong with me?” can conjure up an unlimited number of possible answers, many of which will be completely irrational and add to the anxiety.

For each response we give ourselves to the question we will then ask a set of qualifying questions:
What is the likelihood of that?
What could that lead to?
What does this mean for the future?
How could this affect me?
What is the worst case scenario?