Anxiety

Anxiety is the body's way of responding to being in danger.  Adrenaline is rushed into our bloodstream to enable us to run away or fight.  This happens whether the danger is real, or whether we believe the danger is there when actually there is none.  It is the body's alarm and survival mechanism.  Primitive man wouldn't have survived for long without this life-saving response.  It works so well, that it often kicks in when it's not needed - when the danger is in our heads rather than in reality.  We think we're in danger, so that's enough to trigger the system. People who get anxious tend to get into ‘hyper-alert’ mode - constantly on the lookout for danger, looking for any of the signals and as a result making it all the more likely that the alarm system will be activated. 

Thoughts that often occur:

 

  • I'm in danger right now
  • The worst possible scenario is going to happen
  • I won't be able to cope with it


Physical Sensations - The Adrenaline Response


When there is real, or we believe there is a real, threat or danger, our bodies' automatic survival mechanism kicks in very quickly.  This helps energise us to fight or run away ('fight or flight response').  The action urge associated with anxiety is to escape or avoid.  We will therefore notice lots of physical sensations, which might include:

 

  • Heart racing - This helps to take the blood to where it is most needed – the legs so that we can run faster (flight); the arms so that we can hit out (FIGHT); the lungs to increase stamina.  At the same time blood is taken from the places it is not needed for example fingers, toes and skin.  These changes cause tingling coldness and numbness.
  • Breathing gets faster - This helps the bloodstream to carry oxygen to the arms, legs and lungs.  This will give us more power.  The side effects may include chest pain, breathlessness and a choking feeling.  As there is a slight drop in the blood and oxygen being sent to the brain we may feel dizzy or light headed, he may experience blurred vision.
  • Muscles tense and prepare - The large skeletal muscles tense and create power, this may cause pain, aching and shaking.
  • Sweating - Sweating helps to cool the muscles and the body. It helps to stop them from overheating.  Sweating can also make us more slippery to our enemies!
  • Pupils dilate - This lets more light into his eyes so that overall vision improves.  Side effects may include sensitivity to light or spots before our eyes.
  • Digestive system slows down - These are not important while in danger and so are slowed down then the saved energy goes to where it is most needed.  Side effects may include nausea, butterflies and a dry mouth.
  • More alert - We will be concentrating on looking for danger, much less able to concentrate on anything else.  We're waiting for something to happen.  
     

Behaviours might include:

 

  • Avoiding people or places
  • Not going out
  • Going to certain places at certain times, e.g. shopping at smaller shops, at less busy times
  • Only going with someone else
  • Escape, leave early
  • Go to the feared situation, but use coping behaviours to get you through: examples include: self talk, holding a drink, smoking more, fiddling with clothes or handbag, avoiding eye contact with others, having an escape plan, medication.  These are called 'safety behaviours'.

 

The problem is that safety behaviours actually keep to keep your anxiety going.  As long as you depend on them you never get to find out that you can cope without them or that the anxiety would reduce on its own.
Whilst avoiding people or situations might help you feel better at that time, it doesn't make your anxiety any better over a longer period.  If you're frightened that your anxiety will make you pass out or vomit in the supermarket aisle, you won't find out that won't actually happen, because you don't go.  So the belief that it will happen remains, along with the anxiety.

In CBT we seek to gradually expose you to the situations you might be anxious about while holding new helpful beliefs. You then gather evidence against negative predictions and reinforce the belief that you actually can cope