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11/9/2015

Anxiety - Acceptance and Management

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Catching it Early
If you suffer from chronic anxiety, or panic attacks, there are two generally broad ways to address it.  When you catch it early, there are many ways to manage, it to prevent it from becoming completely overwhelming or exploding into a full blown panic attack. But first, you need to be able to catch it early, which means recognizing the early signs of anxiety that can be unique to the individual.   Some examples of early warning signs that can lead to anxiety include worrying, ruminating thoughts, shallow breathing, light perspiration, lack of sleep, increased stress or unwanted stimulation, poor self-care, dehydration, over-committing yourself, or when your thoughts drift toward the future and are less in the present moment.  Strategies that many find effective who can catch anxiety early include deep breathing, imagery, progressive muscle relaxation, and other mindfulness exercises.  

More Serious Anxiety Attacks
When anxiety is not caught early, symptoms and warning signs can become more severe, leading to full-blown panic attacks.   Common symptoms of heightened anxiety include a sense of dread or impending fear, tightness in chest, tingling in the head or extremities, rapid and/or shallow breathing, rapid heart beat, racing and ruminating thoughts, a sense of helplessness, dizziness or lightheadedness, and sweating.

When symptoms of anxiety are more severe, or if you are experiencing a full-blown panic attack, the key to managing this is not to struggle or become increasingly alarmed as this can actually exacerbate it and make it worse.  The “Oh no, I’m having a panic attack!  I can’t take this! I’ve got to make it stop somehow!” is one of the last things you want to think to yourself as you find that your level anxiety can only increase as a result of this line of thinking.     

Unfortunately this is the experience for many while in a heightened state of anxiety.  While in a full blown panic attack, the event seems to feed on itself, growing in intensity and strength as the sufferer realizes what is happening.  There is an intense need or compulsion to fight against the panic, to desperately do or try anything to avoid what they believe is coming.  Irrational beliefs of a worst case scenario fill the person’s thoughts and can become completely overwhelming; thus launching them into a panic spiral.  The paradoxical thing that happens is that the very struggle to flee anxiety only intensifies the panic, making the symptoms worse, and leaving the person feeling very helpless and powerless to control the anxiety.  While the person attempts to control their anxiety, the act of attempting to regain control, telling themselves to “stop” “relax”, “calm down” l can actually feed the anxiety and make the suffering worse. Sometimes a friend or loved one will say these things too, giving the person experiencing the anxiety attack the impression that its is imperative that they calm down.   I once heard someone say, “Telling someone to relax while experiencing a panic attack is like telling a drowning person to swim.”  

Acceptance & Management (not control)
What many experts in the field now realize is that once anxiety reaches a certain point, it cannot be controlled, per se, but it can be managed and the duration can be greatly reduced, usually through acceptance, recognizing the short-term duration and eventual cessation of an anxiety attack,  and talking yourself through the panic as it happens, recognizing that you are not in imminent harm and that you are not going to die or suffer irreparable injury.   How one manages severe anxiety is important to how effective they can be in doing so. Self-medicating through the use of drugs or alcohol, while offering temporary relief, are ineffective in treating the root of the problem and if fact usually only  make it worse.  Similarly, avoiding anxiety provoking situations only negatively reinforce the anxiety.   Seeking a qualified clinician that is trained in cognitive behavioral therapy specific to anxiety disorders is a good step.  There are also very good self-help books out there to help manage stress and anxiety, including Active Relaxation by Dr. Jennifer Abel, and Get Out of Your Mind and Into Your Life by Steven Hayes.  

While there are many techniques to help you manage or avoid common anxiety, (too many to list here in fact,) what most have in common is to place one’s efforts in the very place where anxiety starts, irrational thinking.  Consider the quote by Irving Berlin,  “Life is 10% what happens to you and 90 % how you take it.”  Being able to challenge or substitute irrational thoughts with accurate but more realistic ways of thinking can minimize the discomfort that anxiety brings to many lives.  Anxiety is one of many normal emotions that everyone experiences from time to time.  Anxiety can be acknowledged and managed.  Frantic efforts to avoid it only exacerbate and enhance its negative effects.    

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11/4/2015

The Anxiety Paradox - When Anxiety is a Problem (and when it is not.)

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The Anxiety Paradox
Anxiety is a funny thing.  Actually  it really isn’t, but it can be very peculiar and confounding.  The more you try to avoid it, the worse it becomes.  Let that sink in for a minute.  The more you work at it and the harder you try to get away from it when you start feeling anxiety coming on, the worse it can  become.   The reason why this paradox is so often true is that more often than not, the individual who is experiencing an increasing state of anxiety, or nearing panic proportions, is not aware of the build up to problematic anxiety until it is too late.  The point here is that once anxiety becomes so uncomfortable, there can often be a panic response from the person that only serves to make the anxiety state worse.  The person then develops a strong urge to do something about it, sort of a fight or flight response, to try to get rid of that seemingly intolerable state of being anxious.  Often an internal struggle ensues, one that includes irrational thoughts and beliefs about the awfulness and intolerability of the state they find themselves in.  This does nothing to decrease the person’s discomfort, and usually serves to exacerbate the situation.  And therein lies the irony of the anxiety paradox.  Struggling is not relaxing and fighting is now calming down.  These are arousal states of being that will make an already stimulated person more stimulated, and worsen their subjective state.  When this happens, some people refer to this as an anxiety attack or panic attack.  

What is anxiety?
The anatomy of anxiety is rather complex as it involves the interplay between and among thoughts, feelings, physical sensations, reactive behavior, and reinforcement of irrational thoughts that trigger anxiety.  Anxiety really begins with a thought or chain of thoughts, and often these thoughts can be irrational.  These thoughts may be based loosely in reality but often times can be unreasonable and not entirely reflective of what is truly happening.  They are based on perception.  Each person’s perception is their own truth.   The stronger the perception, the stronger the belief behind the perception, and the more difficult it can be to challenge a belief that triggers the anxiety.  Once the emotion of anxiety is felt, one usually alters their behavior to decrease the emotional discomfort they experience.  Sometimes that is enough to lessen their anxious state.  Yet sometimes, it can make it worse and reinforce their anxiety.  The important thing to remember is  we all have the capacity to change our perceptions by challenging our beliefs and thoughts.  By doing so, one can alter their perception and help manage irrational thoughts that can lead to heightened states of anxiety.  

Thoughts that lead to worry.
Think about someone who is a frequent worrier.  They more often than not tend to imagine a worst case scenario happening to them.   Someone who is very concerned about being on time may experience the thought, “I’m going to be late and it will be horrible.”  They may fail to recognize that while they may have been late before, the consequences of those past experiences were not nearly as awful as they anticipate the future consequence will be.   Someone with excellent grades may lose sleep over an important exam.  “I can’t sleep because I don’t think I studied enough.  I’m going to do terrible on tomorrow’s exam.”  Again, this person may have excellent grades and the likelihood of getting a bad grade on the next exam, while possible, is still somewhat remote based on past experiences.  Someone who has an interpersonal conflict with one co-worker at work may over-generalize. “I can’t trust anybody anymore.  I hate my job.  I wish I never applied here.”   This kind of person tends to experience very heightened moments of anxiety, characterized by the recurring belief that the worst will happen, when in fact it rarely if ever does.  There may be many aspects of their job they really enjoy but ultimately fail to recognize because they become fixated on one negative experience set apart from many positive experiences they don’t acknowledge.  What these individuals have in common is that, while their experiences might be unpleasant, 1) their perception of a worst case scenario, 2) disregarding information that contradicts their beliefs,  and 3) overgeneralizing leads to an exaggerated perception of what they are experiencing.  

How Anxiety is Reinforced.
Negative ruminating thoughts and worrying can lead to feelings of anxiety, anger, and depression, which then influences behavior, which often results in an attempt to avoid the anxiety provoking situation.  When one avoids the object that one associates with anxiety, it may temporarily relieve uncomfortable feelings, but in reality it actually reinforces the anxiety trigger.  It actually enhances the fear and strengthens the person’s own belief that those fears are valid and should be avoided in the future.  If one has a fear of busy roads and avoids them at all costs because they are SURE that if they drive on the highway, something very bad will happen, they only increase their fear of that situation and enhance their perceived inability to cope.  Continued avoidance only makes it that much harder to drive on the highway in the future.  This is called negative reinforcement.  Negative reinforcement is simply the removal of a perceived unpleasant object that reinforces a way of thinking and behaving.  In this case the avoidance behavior and resulting decrease in emotional discomfort reinforces the irrational belief that the person cannot drive on the highway, which then leads to similar behavior and makes it harder for the person to confront their problematic phobia.     

Triggers for Anxiety
The anxiety trigger can be be a worry, something that you find stressful, or a bad memory you once experienced as very unpleasant and not helpful.  It really is subjective and unique to the person. It can sometimes be difficult for those that experience anxiety to identify triggers that start the anxiety spiral as the person starting to have worrisome thoughts might not even be aware that this is how their anxiety starts.  Sometimes the person is unaware of any thoughts prior to an anxiety attack and perceives that it  comes from seemingly out of the blue.  While this is rare, what is more likely is that the person is simply unaware of the thoughts that lead to a panic or anxiety attack.  

If you are experiencing general anxiety problems or experiencing anxiety or panic attacks,  seeing a professional who is clinically trained to work with anxiety disorders is usually best.  When working with a professional, one of the first things that needs to happen is to get a clearer sense of early symptoms, thoughts, or behaviors that can trigger an eruption of anxiety.  

Check back soon for a more information on how to start managing anxiety more effectively.  



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    Categories

    All
    Addiction
    Anxiety
    Attention Deficit Hyperactivity Disorder
    Depression
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    Impulse Spending
    Less Is More
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    Moving Forward & Personal Empowerment
    Preparing For Counseling
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    Brent Bernard is a Master's Level Licensed Professional Clinical Counselor with over 25 years of experience in the state of Ohio.  

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