Anxiety Guide

• A quarter of Australian men experience anxiety of some kind. So it's really quite normal. It's also important, keeping you safe from harm.
• The dark side is – it can prevent you from living a full and abundant life. It can also have long-term health effects. It can also lead to substance abuse.
• Using scientific reasoning and exposure therapy, we can overcome much of our anxiety. Talking to someone is also popular and effective.

Defining anxiety

Pounding heart, sweaty hands, tightness in your chest?

Anxiety is your fear response kicking in. Fear is your alarm system which triggers your fight or flight (or freeze) response. It's an innate response to a perceived threat of danger. This is great if it’s alerting you to a wild jungle cat ferociously pouncing at you, not so great if it’s just a rustle of the wind in the bushes.

This forms part of our natural 'internal alarm' system. However, if our alarm system isn't calibrated properly or goes off at the slightest provocation, it can cause stress when it isn't helpful... and this is anxiety.

If you feel anxious or stressed in seemingly normal situations, you aren't alone. Anxiety is the most common mental health condition in Australia, affecting one in four men and one in three women.

Men commonly hide behind substances, keeping it bottled up, or in the most unfortunate cases, take their own lives.

Your internal alarm system

If your panic-alarm system is over-active it can have debilitating repercussions.

Now it’s important to note there are two different alarms:

• Panic - immediate threats
• Anxiety - anticipating a threat sometime in the future

Both alarms are extremely adaptive and the more information you feed in the better at doing their thing they become (alarming you). It’s important to realise that although the systems get better, if you are feeding them the wrong information, they are getting better and giving you false alarms – not ideal.

Anxiety's kinda-sorta helpful effects

Let me use this example to illustrate this point:

Last time I went surfing, I saw a shark and it attacked me. Therefore, next time I get in the water I will be anxious that there will be sharks around, and that they will want to attack me. My alarm system will start to produce:

• Anxiety - If I get in the water I might get attacked by a shark and get seriously hurt and die!
• Panic - Every time I see a splash, freak out and paddle like hell

As you may have realised, this can become a problem when your panic system goes off even when the threat is not real. It becomes even worse when it goes off continuously.

Basically, you are not processing risks properly.

If that splash was a fish, or the wind, or nothing, you may feel a bit of embarrassment. After a few splashes you will probably be fine. Maybe a bit "flighty" but eventually your amygdala (centre control for emotion processing) will realise that not every splash is a life-threatening attack.

Effects on the body

Cortisol and adrenaline

When you are feeling stressed or anxious, aka 'feeling the heat', your body starts releasing stress hormones such as cortisol and adrenaline.

Increased heart rate and sweating, yep, these are physical response symptoms caused by the fight/flight hormones pumping through your body.

Long term issues

Anxiety causes cells and organs that compose the nervous system to release hormones that trigger the production of white blood cells (which fight infection) and other disease-fighting elements. This stress-triggered hormone release is essential for priming the immune system to respond quickly to injuries and acute (short-term) illnesses.

This activity is not ideal if it happens continuously for more than a short period of time. Chronic stimulation of the immune system causes the system to become suppressed overall, and thus become less effective at warding off diseases and infections.

The different types of anxiety

There are many different kinds of anxiety that we experience. Here are the most common types to help you understand your own anxieties.

Generalised Anxiety Disorders (GAD)

A person feels anxious on most days, worrying about lots of different things, for an extended period of time. Ever wake up feeling like you’ve been chased by wolves all night? Yeah, that’s probably a bit of anxiety cooking in the ol’ rattle cage.

Social anxiety

Is the fear of being criticised, embarrassed or humiliated, in relatively common situations such as speaking publicly, attending social events or making small talk.

Specific phobias

A person is extremely fearful of a particular object or situation. There are a wide variety of phobias spanning from balloons to travelling via plane. Some people may go to great lengths to avoid their particular phobia.

Panic attacks

Acute panic disorder or panic attacks are intense, overwhelming and often uncontrollable feelings of anxiety combined with a range of physical symptoms. Someone having a panic attack may experience shortness of breath, chest pain, dizziness and excessive perspiration. Sometimes, people experiencing a panic attack think they are having a heart attack or are about to die.

If a person has recurrent panic attacks or persistently fears having one for more than a month, they're said to have panic disorder.

Read more about anxiety disorders at BeyondBlue.

Are you the hunter or the prey?

Here are a few stories from psychologist Luke Vu, PhD. Some other great content can be found on his blog.

Stop being hunted...

Imagine we are in the African Savannah and we had to fetch water. There were a few times where you went to fetch water and you’ve been attacked by a lion. You’re going to be really anxious; concerned in general about when (not if) you’re going to be attacked.

Now this is a really tough feeling, because long-term non-specific anxiety impacts on your health and your psychological wellbeing. Before long you might want to stop going to fetch water, and your thoughts may change to “I didn’t want to get water anyway”.

Constantly avoiding lions sounds like a good idea but comes at a cost. You have to deal with the anxiety everyday…single…day… It’s exhausting on your body and on your mind. Now, what if I could offer offer you a deal...

...and become the hunter

What if you could tap into your predatory systems of fear and re-harness that fear into something productive, powerful and comfortable?

One day you’re sick of being afraid of being attacked by lions. You’re so sick of lions that you suddenly decide to hunt the lion! Then something magical happens, a switch flips in your mind.

You switch to a goal oriented mind and you become a problem solver.

How to stalk your new prey

You start to think about how you would even approach this problem. Your thoughts may change towards “Do I know how to make a spear? Do I know where lions hang out? Are you going to need to recruit friends to help you hunt this lion?"

Now this mindset is very powerful because the risk to you still the same to you, death by lion, but now you’re hoping to run into that lion.

Now you’re motivated to approach the very fear that you tried to avoid. Most people, once they adopt this mindset start to deal with anxiety much more effectively.

Using drugs and alcohol for safety

Using drugs and alcohol for safety is a common occurrence.

Are you still afraid of the dark?

Now it’s very likely your fear system works very well in another context. A common example is the 'fear of the dark'. Over time, and the fact that exposure to night is unavoidable, your fear system can calibrate to manageable levels as you awake each morning unscathed, with no monster encounters.

If however, the child was given a protection mechanism, a night light, or a special helmet of safety, and nothing happens that night, the safety is attributed to the helmet. Your fear system quickly learns that the helmet is what keeps you safe.

What happens when you don’t have your helmet? The fear comes rushing back with a vengeance. It makes sense right? If the helmet was the reason for your safety, and now you don’t have the helmet, then now your brain believes you are unsafe.

Safety behaviours and blankets

Psychologists call this a 'safety behaviour' and makes the fear and anxiety much worse. It often gets in the way of improvement. For adults we see these ‘safety helmets’ all the time. This can come in the form of substance abuse.

For social anxiety, it might be a bit of 'Dutch courage' or some other, more serious confidence booster or relaxant. This can become a major problem, as people with anxiety can depend on alcohol or drugs to push through anxiety or dull its effects.

Regardless of the helmet, the premise is the same: it is easy to become reliant on substances to help with intimidating situations.

Fearing fear itself

If we flee from the thing we are afraid of, or even avoid the scenario entirely, the fear is likely to get worse:

1. A specific event happened that your intelligent brain has decided to be afraid of. Let's use sharks again.
2. Left unsolved, or unresolved, the problem continues to escalate. I never see that the splash isn’t a life threatening shark attack.
3. Since the problem is escalating, well it only makes sense that the fear also escalates. Let’s just stay out of the water entirely, it’s safer that way. If I go in, I might get attacked again.
4. The avoidance of fear experiences makes it impossible for the fear system to calibrate itself down. If you never see a splash that isn’t a shark attack, your amygdala (remember the lizard-brain almond) can’t learn that a splash isn’t shark.

Out of the water

Now the shark example is a bit extreme, but what about these:

• “If I go to that cafe, I might run into my ex…”
• “if I don’t meet my quota by this month I might get fired”
• “if my bus doesn’t come in the next minute I will be late and I will get sprayed by my boss”
• “if I don’t say the right thing…”

Not so extreme, right?

Your anxiety tool kit

Reason your way out

Firstly it can be extremely helpful to examine your beliefs and restructure them. This entails stepping outside your box an examining yourself through a logical lens.

Evaluate the evidence in a way that reframes your fear.

"What do I think would be the worst outcome?" "What is so bad and dangerous about this situation that is so frightening?

The non-judgemental observer

The ultimate goal of taking the observer role may require a bit of practice but it will allow you to re-evaluate the likelihood and magnitude of the actual threat in a specific way.

Often things are a lot less frightening when the cloud of ambiguity is taken away and ultimately you will be in a much stronger position for dealing with your stress.

Dr. Albert Ellis, father of Rational Emotive Behaviour Therapy (a precursor to CBT, which we will discuss later) calls this unhelpful rumination "musterbation" - "I must" or terrible things will happen to me.

For example:

1. If I don’t sleep well tonight I might sleep through my alarm clock.
2. If I sleep through my alarm I will be late for work.
3. If I’m late my boss will absolutely grill the shit out of me.

Fear fear fear!

Escaping the fear trap

If we hit this with a sack of logic we can cut through the spiral of fear.

1. I will set two alarms and there is no reason why they won’t wake me up.
2. If my boss does grill me, well, they are just words and I’m in no real, physical danger.
3. After all, fear is an emotional response to physical danger, in a professional setting specifically, you are vary rarely in any real danger.

If that helps you master it, fantastic. If not, on to the next…

Getting through it

Now in the case where you can logically see the cause of your anxiety is irrational, your limbic system (part of brain that controls emotions) might not be buying it.

In this case, there is no way around this, you have to face your fear.

Progressive desensitisation or the 'ladder technique'

This technique is backed by loads of psychologists and consists of gradually building up to doing what you’re afraid of.

This technique gives you time to overcome little fear hurdles over and over so that you get better at overcoming fear and that the fear itself is not so insurmountable.

Think of it like big wave surfing. No one paddles straight into a 40ft ship-stern monster the first time they mount a board. The usual 'ladder' looks like:

1. Ride two-foot wave

2. Ride three-foot wave

3. Ride four-foot wave

n...? Ride 40ft wave!

Each time you increment higher and overcome a little bit of fear. Soon you will be going from 12 to 15ft, with a similar increase in fear as to when you went from three to four foot.

Mark Mathews, said lunatic who paddled into a 40ft ship-stern monster, admitted he was always afraid of waves. His mum would have to come out and rescue him because he was too scared to paddle back in or catch a wave.

The ABCs of CBT

This is a very common technique used in CBT, or cognitive behavioral therapy that helps alleviate anxiety: You do the easiest thing in the category of what you’re trying to do, and then slowly work your way up to the “scariest” thing.

A specific step by step approach can be found here.

Dissect

The third is digging in and understanding why this particular anxiety exists in the first place and recognising that it isn’t such a bad thing.

In fact, the anxiety itself can be used to motivate behaviour change. This can be a bit tougher to do on your own and may be worth speaking with a psychologist.

LYSN is a great online platform that that puts you in touch with psychologists without having to leave the house.

The way out

Anxiety cannot be cured - but it can be conquered. By recognising your own type of anxiety and using Rational Emotive or Cognitive Behavioural therapies, you can master your anxieties so they don't affect your day-to-day life.

Anxiety is a persistent 'junkyard dog' as opposed to depression's 'black dog'.

The junkyard dog is always on guard for intruders and crooks, and it's always barking away. However the world is not as dangerous as we think and we can take steps to remove anxiety from our lives so it no longer dominates our thoughts and actions.

If you or someone you know is in immediate danger or at risk of harm, call 000.