To have suffered from anxiety at some point in our lives basically means being human. However, not all anxiety is created equal — it manifests in a range of ways, and as a result, can impact each of us differently. Here’s the DL on what, exactly, causes this state of mind and how to cope when it gets out of hand.
While anxiety comes in a slew of forms — from obsessive-compulsive disorder, to panic and phobias, there are two that are the most common. One is connected to the body’s flight-or-fight response. “Anxiety can be a healthy stress response that gives you the focus and strength to get out of danger — it can help you get out of the way of an oncoming car or an attacker, for example, but if you feel that way about all situations, even when you aren’t at risk, that’s when it’s more of an anxiety disorder,” says Eudene Harry, MD, medical director of Oasis Wellness & Rejuvenation Center, an integrative holistic lifestyle clinic in Orlando, Florida and author of Anxiety 101: The Holistic Approach to Managing Your Anxiety and Taking Back Your Life. The other most frequent case is tied to social situations, striking when, for example, you're on a date, giving a presentation, or at a party meeting new people.
These forms, as well as all of the variations of anxiety, are way more prevalent than you might think: In fact, anxiety disorders are the most common mental illness in the U.S., according to the Anxiety and Depression Association of America, with more than 40 million adults — and more women than men — affected by it.
So what's the underlying cause? While the physiological response can be extremely powerful, it's your brain's perception of a negative situation that's instigating it. “Because when you’re, say, at a party, it is one’s thoughts that are actually generating the anxiety — it’s not the situation itself,” says Harry. “Or that presentation you have to give isn’t putting you in any real danger that should instigate anxiety.”
In other words, one person can easily step up to a podium and be cool and calm, while another is notably worked up, depending on their estimation of the situation. How do we stop from being the latter? While it is not entirely simple to avoid, it can help to think about it like this: As with any emotional meditations, change your thought pattern and you can alter your anxious response. Because if you continue to look at certain situations through that one not-so-good-for-you emotional filter, then you will continue to feel the same emotion — like anxiety — over and over again.
Of course, in theory, this sounds easy. But, in reality, it might be a little tougher, and for those with extreme anxiety, impossible. “We know that anxiety is a multi-leveled disorder that integrates many parts of the body, including the immune system, the gut, and the brain,” explains Harry.
Even more confusing is that in everyday life, anxiety is often synonymous with stress and worrying, and it’s not always easy to see the difference between the three. “Again, stress is a biological response in the body to events or situations that seem to present a possible threat,” explains Harry. “The stress response can be triggered by something physical such as an infection, emotional such as a breakup with a significant other, or an external threat such as being chased by a dog — it only becomes distress when your ability to cope is exceeded and you start feeling overwhelmed and powerless.”
However, when it comes to interchanging worry with anxiety, the lines are a little less distinct. “We have all experienced some form of worry,” says Harry. “It becomes an issue, when worrying becomes constant and chronic, and we constantly feel that something bad is going to happen. Often times that feeling of unease is so pervasive that you can no longer identify the cause of your unremitting concern.”
And, research shows that there is a definite link between depression and anxiety — possibly, Harry says, from a decrease in the neurotransmitter serotonin, which plays a role in keeping us calm and happy, and why a doctor may prescribe an antidepressant such as an SSRI to help address anxiety symptoms, too. “If you live in a state of constant fear and you see no way out and you begin to feel powerless to change it, this can certainly trigger despair and a sense of hopelessness, or depression,” explains Harry. “It has been shown that the biology and physiology of depression and anxiety may also share similar pathways and mechanism.”
The good news: When it comes to treating a moderate level of anxiety issues, there are plenty of natural ways to cope. First off, steer clear of any stimulants that would make you more anxious than you already are. That means caffeine (including coffee and energy drinks), nicotine, and alcohol, as well as drugs like cocaine, of course. Also, be aware of common-sense lifestyle tweaks that can help keep you calm and anxiety-free — for example, lack of sleep and extreme stress are proven anxiety-boosters. So, get to bed early and try to keep your stress at a manageable level.
And, while breathing techniques sound all New Age-y to some, Dr. Harry says that if you look at breath from a physiological standpoint, you realize it’s really the best natural anxiety fix. “Deep breathing activates the system that is able to naturally calm the body,” she says. “When we breathe in, our heart rate goes up, and when we exhale, it slows it down and the calming parasympathetic system comes into play.” Here are some numbers to put it in perspective: On average, people can breathe 14 to 16 times a minute (which is way too fast by the way), even when not super-anxious. But, if you slow that down to six to 10 times per minute, the body gets a boost in oxygenation, a feeling of energy, and you feel less tired. “When you start breathing fast, you are triggering a response that makes your brain think there is trouble, and you could end up being in that state all the time!” she says. And, be sure to keep workouts consistent — be it a gym class or even a light jog or walk as they can help decrease anxiety in the long run. What’s especially crucial: Keep up the exercise even when you aren’t actually feeling anxious. “Exercising makes the brain healthy, decreases inflammation, and lowers adrenaline levels, so you’re no longer bathing in things that drive that anxiety response when anxiety situations do occur,” she says.
Another proven element of curbing anxiety is understanding why you are anxious. “Before you think you are going to feel anxious, write down what you think is causing it and replace that emotion,” says Harry. For example, instead of saying in your head, "I’m going to mess X, Y, and Z up, and I’m going to look like I don’t know what I’m talking about,” you should say "I am totally capable of this." "Often your emotional brain is in charge, but, by doing this, you can put your intellectual brain in charge, instead. You need to be able to say, ‘Wait this is not a dangerous situation and it will be okay’,” she says.
Dr. Harry points out that there are extreme cases where anxiety is through the roof, and a chemical imbalance in the brain could be to blame. In these cases, without a doubt, professional help should be looked to ASAP. And, it's possible that medication could be the missing anti-anxiety link. Typically, for general anxiety as well as phobias, doctors prescribe benzodiazepines — medications like Xanax, Valium, Klonopin. For more social-anxiety issues, medications might include beta-blockers like Inderal — to use only when one is in extreme duress (i.e. going on a plane when you are afraid of flying or having to get an MRI and you can't handle enclosed areas). “Doctors prefer to keep benzodiazepines for short-term use only because of their addictive potential,” says Harry. “It’s preferred to use SSRIs or other anti-anxiety meds for ongoing anxiety along with exposure therapy to a phobia, for example.”
“When an anxiety response is too strong, one may need a medication to bring into a normal range to even be able to go forward with a therapy — but it is so important that medication alone is not used and that the cognitive work is done to really tap into what correlating emotions and underlying thoughts are driving the anxiety,” she says. However, medications commonly prescribed for anxiety can have troubling side-effects, so working closely with an understanding doctor and counselor is so important.
The bottom line: Freaking out when you have to go in front of a large group or socialize at a big party is 100% normal. But, when anxiety stops you from doing things that make you happy — you skip the birthday bash, or don’t speak up at work and miss out on a promotion — that’s when seeking help could be the feel-calmer game-changer.
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