Living with Anxiety
Anxiety can be challenging to live with but there are many effective ways to cope with it. Find the combination that works for you.
Of all existing psychological and mental maladies, anxiety disorders are the most common affecting over 30% of all adults in the United States. Anxiety disorders are a broad category that includes many different manifestations of anxiety including:
- Generalized anxiety disorder (GAD): Excessive anxiety or worry about an array things such as personal health, work, social interactions, and everyday routine life circumstances
- Specific phobia: An intense fear or aversion to specific situations, things or places that is out of proportion to the actual danger caused by the situation or object.
- Social anxiety: Excessive worry about actions or behaviors in social or performance situations and a fear of feeling embarrassed causes those with social anxiety to avoid social situations–gatherings, parties or events—leading to a kind of self-imposed isolation.
- Panic disorder: Episodes of intense fear that come on quickly and reach their peak within minutes. Attacks can occur unexpectedly or can be brought on by anxiety or a trigger, such as a feared object or situation
Anxiety isn’t all bad. Sometimes it’s a life-saver. It’s an evolutionary trait meant to protect us from marauding animals and other dangers. In a normal measure, anxiety is an alarm system (marauding beasts) and a motivator, the push needed to finish a project on time or meet a deadline (what I experienced writing this article). But when anxiety exceeds its benign function as a temporary motivator, when it overflows its banks, flooding the mind with toxic thoughts and poisonous worries and monkeying with the body’s stress hormones, havoc ensues. Thousands of years ago, the Buddha described the chaos and havoc of the monkey mind, a state where unruly monkeys—thoughts and fears– collided into each other creating stress and anxiety.
Anxiety, Mind, and Mayhem
That theme carries over in Monkey Mind: A Memoir of Anxiety by Daniel B. Smith. Describing himself as “anxiety personified,” Smith writes, “Anxiety compels a person to think, but it is the type of thinking that gives thinking a bad name: solipsistic, self-eviscerating, unremitting, vicious. My walks to therapy, for example, were spent outlining with great logical precision the manner in which my state of mind would lead me to complete existential ruin. A typical line of thought went something like this: I am anxious. The anxiety makes it impossible to concentrate. Because it is impossible to concentrate I will make an unforgivable mistake at work. Because I will make an unforgivable mistake at work, I will be fired. Because I will be fired, I will not be able to pay the rent.”
That torturous, negative thinking pushes the thinker into an ever more anxious state. Anxiety not only begets anxiety, it also causes physical reactions. The body responds to anxiety and fear by releasing cortisol and other stress hormones that can lead to a buffet of symptoms ranging from dizziness, heart palpitations, sweating and lightheadedness to nervousness, flushing, trouble concentrating, rashes and more. Moreover, living with anxiety can be a lonely and isolating experience. As one sufferer lamented, “it’s not visible, people don’t understand it and too often think willpower can make it go away.”
Celebrities Living with Anxiety
In recent years, as more and more celebrities reveal their own struggles with anxiety, these disorders seem to be emerging from behind the curtain and stepping onto the world stage. In a recent Peoplemagazine interview, singer and songwriter, Jewel, spoke about the panic attacks, anxiety, and agoraphobia that plagued her from the age of 15. Now 44, she credits journaling and meditation with helping her manage her anxiety. She recently shared a YouTube video of two mindfulness/meditation exercises she regularly uses to calm and center herself.
Anxiety has been a constant, unwanted companion in actor Ryan Reynold’s life. In a New York Times,interview the Deadpool actor revealed, “I’ve always had anxiety….Both in the lighthearted ‘I’m anxious about this’ kind of thing, and I’ve been to the depths of the darker end of the spectrum, which is not fun.”
For Reynolds, performing helps him manage his anxiety, a practice that also works for late show host Stephen Colbert. In a recent Rolling Stone interview, Colbert said that he “needed to be medicated when I was younger to deal with my anxiety…” After he married, he had “a bit of a nervous breakdown… — kind of panic attacks,” he said. “My wife would go off to work and she’d come home—because I worked at night—and I’d be walking around the couch. And she’s like, “How was your day?” And I’d say, “You’re looking at it.” Just tight circles around the couch.” “I would go to the show, and I would curl up in a ball on the couch backstage and I would wait to hear my cue lines,” he said. “Then I would uncurl and go onstage and I’d feel fine. Which occurred to me at the time: Like, ‘Oh, you feel fine when you’re out here.’ And then as soon as I got offstage, I’d just crumble into a ball again…”
The take away is that while anxiety disorders share certain behaviors and characteristics, how an individual experiences agoraphobia, GAD or a phobia differs and is influenced by that person’s psyche and life experiences, biology and perhaps their DNA.
The standard treatments for anxiety disorder are:
- Cognitive behavioral therapy (CBT), is based on the idea that our thoughts cause our feelings and behaviors, not external things, like people, situations, and events. The benefit of this therapy is that we can change the way we think to feel and act better even if the situation does not change. CBT focuses on determining the thought and behavior patterns responsible for sustaining or causing anxiety or panic attacks.
- Dialectical Behavior Therapy (DBT) is a form of cognitive therapy that emphasizes individual psychotherapy as well as group skills training to help people learn new skills and strategies—including mindfulness and distress tolerance–to manage their anxiety and panic.
- Exposure therapy involves exposing the patient in a safe and controlled environment to physical sensations they experience during an anxiety or panic attack. The idea is that by repeating the things that may trigger a panic attack those triggers will eventually lose their power.
- Medication can be used to control or lessen symptoms related to anxiety disorder. It is most effective when combined with other treatments, such as the aforementioned cognitive behavioral therapy and exposure therapy. Medications used to treat panic disorder include antidepressants, though they take several weeks to reach effectiveness. Benzodiazepines such as Ativan and Xanax work quickly. However they are addictive and should only be used for a short time,
While these classic treatments have a good success rate, treatment options are expanding.
One anxiety-alleviating method much discussed recently is a practice called Tapping, otherwise known as EFT or Emotional Freedom Techniques. First developed in the 1980s, Tapping combines ancient Chinese acupuncture–minus the needles—and modern psychology explains Nick Ortner, author of The Tapping Solution: A Revolutionary System for Stress-Free Living. The basic idea of Tapping is that you identify something that is anxiety-provoking or stressful. You then go through the designated meridian points in a specific order saying something positive like, “Even though I’m stressed or anxious about this, I deeply and completely accept myself.” The meridians in order are:
- The side of the hand: Outside of your hand below your fingers (the Karate Chop Point) tap with four fingers
- Head: The crown, center, and top of the head. Tap with all four fingers on both hands.
- Eyebrow: The inner edges of the eyebrows, closest to the bridge of the nose. Use two fingers.
- The side of the eye: The hard area between the eye and the temple. Use two fingers. Feel out this area gently so you don’t poke yourself in the eye!
- Under the eye: The hard area under the eye that merges with the cheekbone. Use two fingers, in line beneath the pupil.
- Beneath the nose: The point centered between the bottom of the nose and the upper lip. Use two fingers.
- Chin: This point is right beneath the previous one, and is centered between the bottom of the lower lip and the chin.
- Collarbone: Tap just below the hard ridge of your collarbone with four fingers.
- Underarm: On your side, about four inches beneath the armpit. Use four fingers.
And back to the head to complete one sequence. As you tap on each meridian, keep repeating your positive phrase such as “even though I’m anxious about (fill in the blank), I accept myself. As you go through the rest of the meridians, repeat a simple reminder phrase, such as “my anxiety” or “my interview” or “my financial situation.” This sequence should be repeated several times. The technique has garnered approval from the Veteran’s Administration for the treatment of PTSD. And a 2016 study by Ben-Gurion University of the Negev concluded that the “Emotional freedom technique treatment demonstrated a significant decrease in anxiety scores, even when accounting for the effect size of control treatment.” However, the researchers pointed out that more studies are needed.
More Anxiety Antidotes
Early in her career, Los Angeles-based author, actor and TV personality Terra Wellington would get panic attacks just before going on air. “It was like an out-of-body experience,” says Terra. “I would also not breathe enough to get the oxygen I needed, so I would feel light-headed.” Over the years, she came up with a few simple anxiety and stress reduction skills that she still uses. Along with practicing mindful breathing to calm her, she uses a grounding technique. “I purposely wiggle my toes and tell my feet to feel the floor, even with shoes on; if I can ‘feel’ the floor under me, I’m more grounded,” she says.
Rob Cole, a licensed mental health counselor and the clinical director of Mental Health Services at Banyan Treatment Center suggests these grounding and other anxiety-reducing techniques.
- Take a moment to center yourself and bring yourself back into the present moment. Tune into 4 things around you that you can see, 3 things that you can touch, 2 things that you can smell, and 1 thing that you can taste (you can carry around mints, or gum, to use in this situation). You will distract yourself from the anxiety that is trying to take over your body.
- Carry loose change or count backward by 3’s. These techniques help those who are about to have a panic or anxiety attack by forcing the brain to focus on another, overriding activity. The act of counting at random intervals helps people to focus, overriding the anxious thoughts that are trying to creep in. Loose change is a great way to do this. Add a dime to a nickel and you have 15. Add another two pennies and you have 17, so on and so forth. By showing yourself that you are capable of controlling your thoughts by this systematic, deliberate counting, and focusing on something outside of yourself, you will begin to feel calmer. Similarly, count backward from 100 by intervals of 3. This is another way to force your brainpower onto a task that is not your anxious thoughts, allowing you to regain control of the situation.
- Progressive muscle relaxation. Using relaxation exercises can be an effective way to reduce your stress and anxiety. Alternate between tensing and relaxing different muscle groups throughout the body. Tensing your muscles is a common symptom of anxiety and by learning to immediately relax those muscles you’ll program your body to relax when it feels the tension.
- Focus on one single task at a time. You will instantly feel less overwhelmed. If you are in the car, focus on staying in the middle of the lane. If you are at work or school, take care of the most important thing you need to do that day. Focusing on a single activity distracts your mind from the anxiety it is producing.
And speaking of activity, find something, be it coloring, doing a crossword puzzle, writing, knitting or anything else that occupies your hands and your mind will help keep anxiety at bay. Living with anxiety doesn’t have to feel like a life sentence. Take a proactive role in your own mental health treatment and find techniques that work for you to help manage your anxiety.